Purchase this article with an account.
Matthias Neuburger, Christian van Oterendorp, Thomas Wecker, Daniel Boehringer, Thomas Reinhard, Jens F. Jordan; The Trabectome - First European Clinical Results and Subgroup Analysis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5930.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
In most forms of open angle glaucoma the trabecular meshwork (TMW) is the main barrier for aqueous humor outflow, causing elevated intraocular pressure (IOP). The Trabectome is a new device particularly eliminating the juxtacanalicular meshwork using a minimal invasive surgical approach. The aim of this study was to evaluate its effectiveness and clinical feasibility in primary and secondary open angle glaucomas.
187 eyes of 176 patients with primary or secondary open angle glaucoma were included into this prospective study. Intra- and postoperative complications were documented systematically. TMW was removed for 90 to 120 degrees in the nasal circumference using the gonioscopic approach. Main outcome measures were IOP reduction over time and pre- and postoperative number of medications.
Mean preoperative IOP was 25 ± 6mmHg, under mean 2 IOP lowering topical medications. On postoperative day one, mean IOP was 13 ± 6mmHg. After a mean follow-up of 390 days, IOP was reduced to 17 ± 2mmHg. Mean number of IOP lowering drops was simultaneously reduced to n=1.5. Subgroup analysis revealed the strongest IOP lowering effect for pseudoexfoliative, pigmentary and steroid-induced glaucoma (mean -37%, max -60%). Best reduction in topical medication was found in NTG (-65%). When combined with cataract surgery, the IOP lowering effect (-27%) and the reduction of IOP lowering drops (-77%) was higher than for the Trabectome alone (-23% and -45%, respectively). No serious complications or adverse events were recorded so far.
The Trabectome proved to be a feasible device for nonpenetrating glaucoma surgery. The results of this first independent prospective study underline the effectiveness of this method. Further, its minimal invasive approach and the lack of ocular surface alterations make it a valuable addition for glaucoma surgery.
This PDF is available to Subscribers Only