Efficacy and safety of ab interno trabeculectomy in juvenile open-angle glaucoma

Sourabh Arora; Masahiro Maeda; Brian Francis; Mariko Maeda; Arthur J Sit; Sameh Mosaed; Samir Nazarali; Karim F Damji

doi:10.1016/j.jcjo.2017.12.013

Efficacy and safety of ab interno trabeculectomy in juvenile open-angle glaucoma

Can J Ophthalmol. 2018 Oct;53(5):482-486. doi: 10.1016/j.jcjo.2017.12.013. Epub 2018 Mar 14.

Authors

Sourabh Arora¹, Masahiro Maeda², Brian Francis³, Mariko Maeda⁴, Arthur J Sit⁵, Sameh Mosaed⁶, Samir Nazarali⁷, Karim F Damji⁸

Affiliations

¹ Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta.
² Yasuma Eye Clinic, Nagoya, Japan.
³ Department of Ophthalmology, University of Southern California, Los Angeles, CA.
⁴ Maeda Eye Clinic, Osaka, Japan.
⁵ Department of Ophthalmology, Mayo Clinic, Rochester, MN.
⁶ Department of Ophthalmology University of California Irvine, Irvine, CA.
⁷ Faculty of Medicine, University of Ottawa, Ottawa, Ont.
⁸ Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta.. Electronic address: kdamji@ualberta.ca.

PMID: 30340716
DOI: 10.1016/j.jcjo.2017.12.013

Abstract

Objective: To determine the efficacy and safety of ab interno trabeculectomy with Trabectome in juvenile open-angle glaucoma (JOAG) patients.

Design: Prospective cohort study.

Methods: Evaluation of the 12-month results of 2 patient groups receiving ab interno trabeculectomy: group 1, eyes with no prior incisional surgery; group 2, eyes that had prior incisional cataract or glaucoma surgery.

Results: Group 1, 40 eyes (average age 31 ± 7 years), had a significant reduction in intraocular pressure (IOP) of 10.6 mm Hg at 12 months from a baseline of 27.4 mm Hg (p = 0.01), and the number of glaucoma medications reduced by 0.4 (p = 0.80). Four eyes (10%) within the study period required a secondary glaucoma surgery. Group 2, 20 eyes (average age 27 ± 8 years), had a significant reduction in IOP of 8.8 mm Hg from a baseline of 27.1 mm Hg (p = 0.06), and the number of glaucoma medications reduced by 1.4 (p = 0.36). Five eyes (25%) from this group underwent a secondary glaucoma surgery within 12 months.

Conclusion: After 1 year of follow-up, ab interno trabeculectomy appears to be an effective and safe intervention for patients with JOAG; however, a reduction in use of topical medications may not be observed in those receiving ab interno trabeculectomy as a primary procedure.

MeSH terms

Adolescent
Adult
Child
Female
Follow-Up Studies
Glaucoma, Open-Angle / physiopathology
Glaucoma, Open-Angle / surgery*
Humans
Intraocular Pressure / physiology*
Male
Prospective Studies
Tonometry, Ocular
Trabeculectomy / methods*
Treatment Outcome
Visual Acuity*
Young Adult