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J Glaucoma. 2012 Feb;21(2):71-5. doi: 10.1097/IJG.0b013e31820bcfda.

Effect of a failed trabectome on subsequent trabeculectomy.

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  • 1Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.

Abstract

PURPOSE:

To determine the effect of a failed trabectome on the outcomes of a subsequent trabeculectomy.

PATIENTS AND METHODS:

A cohort study of eyes that underwent trabeculectomy after a failed trabectome procedure (study) compared with eyes that underwent trabeculectomy as an initial surgical procedure (control). Inclusion criteria were open-angle glaucoma, age ≥18 years, and uncontrolled glaucoma with maximally tolerated medical therapy. Exclusion criteria were concurrent surgery and follow-up less than 6 months. Outcome measures were intraocular pressure (IOP), success rate, and occurrence of complications. Failure was the occurrence of additional glaucoma surgery, loss of light perception vision, or IOP >21 mm Hg, ≤5 mm Hg, or <20% reduction below baseline on 2 consecutive follow-up visits after 1 month.

RESULTS:

Mean follow-up was 15.4 months and 18.6 months for study (n=34) and control (n=42) groups, respectively. IOP decreased from 27.6±11.8 mm Hg at baseline to 10.6±2.6 mm Hg at 2 years in study group, and 29.2±11.4 mm Hg to 11.0±5.4 mm Hg in the control group. The success rates at 2 years were 60.2% and 55.5% in the study and control groups, respectively (P=0.895). Systemic hypertension [P=0.009; adjusted hazard ratio, 4.03; 95% confidence interval, 1.41-11.53] and number of the preoperative antiglaucoma medications (P=0.005; 2.29; 1.28 to 4.11) were significant risk factors for failure in the multivariate analysis. Failed trabectome was not associated with trabeculectomy failure (P=0.899). Postoperative complications were similar.

CONCLUSIONS:

A failed trabectome did not affect the success rate of a subsequent trabeculectomy.

PMID:
21336149
[PubMed - indexed for MEDLINE]
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