June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Surgical outcome of trabeculectomy with phakia, pseudophakia, and phaco trabeculectomy for open-angle glaucoma - Utilizing the data from the Collaborative Bleb-Related Infection Incidence and Treatment Study
Author Affiliations & Notes
  • Yuji Yamamoto
    Ophthalmology, Kyoto prefectural university of Medicine, Kyoto, Japan
  • Kazuhiko Mori
    Ophthalmology, Kyoto prefectural university of Medicine, Kyoto, Japan
  • Isao Yokota
    Biostatistics, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • Kengo Yoshii
    Mathematics and Statistics in Medical Sciences,, Kyoto prefectural university of Medicine, Kyoto, Japan
  • Yoko Ikeda
    Ophthalmology, Kyoto prefectural university of Medicine, Kyoto, Japan
  • Morio Ueno
    Ophthalmology, Kyoto prefectural university of Medicine, Kyoto, Japan
  • Kojiro Imai
    Medical Innovation and Translational Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi Kamigyouku Kyoto, Japan
  • Satoshi Teramukai
    Biostatistics, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • Shigeru Kinoshita
    Frontier Medical Science and Technology for Ophthalmology, Kyoto prefectural university of Medicine, Kyoto, Japan
  • Chie Sotozono
    Ophthalmology, Kyoto prefectural university of Medicine, Kyoto, Japan
  • Footnotes
    Commercial Relationships   Yuji Yamamoto, None; Kazuhiko Mori, None; Isao Yokota, None; Kengo Yoshii, None; Yoko Ikeda, None; Morio Ueno, None; Kojiro Imai, None; Satoshi Teramukai, None; Shigeru Kinoshita, None; Chie Sotozono, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4940. doi:
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      Yuji Yamamoto, Kazuhiko Mori, Isao Yokota, Kengo Yoshii, Yoko Ikeda, Morio Ueno, Kojiro Imai, Satoshi Teramukai, Shigeru Kinoshita, Chie Sotozono; Surgical outcome of trabeculectomy with phakia, pseudophakia, and phaco trabeculectomy for open-angle glaucoma - Utilizing the data from the Collaborative Bleb-Related Infection Incidence and Treatment Study
      . Invest. Ophthalmol. Vis. Sci. 2017;58(8):4940.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare the surgical outcomes of initial trabeculectomy (TLE) with lens status (TLE with phakia, pseudophakia, and phaco TLE) for open-angle glaucoma (OAG) utilizing data from the Collaborative Bleb-Related Infection Incidence and Treatment Study (CBIITS), a multicenter prospective cohort study conducted by the Japan Glaucoma Society.

Methods : This observational study involved 467 primary OAG or exfoliation glaucoma patients out of 1,098 cases from the CBIITS data sets. Intraocular pressure (IOP) and bleb shape were described at 6-month intervals throughout the 5-year follow-up period. Bleb morphology was evaluated by the characteristics of width (W) and depth (D). IOP and each bleb characteristic were compared among the three groups. Surgical failure was defined using the following IOP levels at 2 consecutive visits: 22mmHg [criterion (crit)-A], 19mmHg (crit-B), 16mmHg (crit-C), or greater. Bleb failure was defined as blebs became smaller than the scleral flap size at W or D (crit-W, or crit-D, respectively). When additional glaucoma surgery was required and performed, it was regarded as a failure for all criteria. The Cox proportional hazards regression model was used after adjustment for sex, age, those with a fornix- or limbal-based flap, subtype of OAG, preoperative IOP, and number of preoperative topical anti-glaucoma medications used.

Results : Of the 1,098 cases, 319 underwent TLE with phakic eyes (TLE_phak), 98 underwent phaco TLE (phaco TLE), and 50 underwent TLE with pseudophakic eyes (TLE_IOL). The failure-free advantage in favor of the TLE_phak to phaco TLE, and TLE_IOL was HR: 0.58; 95%CI: 0.31-1.13, HR: 0.80; 95%CI: 0.37-1.95 for crit-A, HR: 0.50; 95%CI: 0.28-0.92, HR: 0.53; 95%CI: 0.27-1.11 for crit-B, HR: 0.64; 95%CI: 0.41-1.02, HR: 0.54; 95%CI: 0.33-0.90 for crit-C, and HR: 0.43; 95%CI: 0.26-0.72, HR: 0.51; 95%CI: 0.28-0.98 for crit-W and HR: 0.63; 95%CI: 0.41-0.98, HR: 0.77; 95%CI: 0.45-1.37) for crit-D. The failure-free period of the TLE_phak was statistically longer than those of the phaco TLE or TLE_IOL during the 5-year follow-up period in all criteria.

Conclusions : TLE with phakia may maintain lowest IOP and best filtering blebs compared with phaco TLE or TLE with pseudophakia.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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