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Constance Okeke, Eydie G Miller-Ellis, Nils A Loewen; Factors Associated with Successful Outcomes in Trabectome Only Surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3174.
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Surgical outcomes can be enhanced by identifying the proper patient. Our objective is to investigate which risk factors and patient characteristics are associated with success or failure in Trabectome only surgical procedures.
594 patients who underwent Trabectome only with at least 12 months of follow-up were included in the analysis. Baseline demographics and medical data were collected. Failure was defined as IOP>21mmHg, IOP reduced by less than 20% from baseline on any two consecutive visits after 3 months and if secondary glaucoma surgery was performed. Risk factors for failure were determined by using univariate and multivariate Cox regression with time-varying variable. The following factors were studied: age, gender, race, diagnosis, and visual field.
Of the Trabectome only study group, majority were Caucasians (61%), female (55%) with a mean age of 67±16 and diagnosed with primary open angle glaucoma (POAG) (75%). At baseline, IOP was 24.3±7.7mmHg and number of medications was 2.7±1.3. At 12 months, IOP was 16.4±3.9 (p<0.01) and number of medications was 2.0±1.3 (p<0.01). The survival rate at 12months was 77%. Multivariate analysis showed that diagnosis of pseudoexfoliative glaucoma has a 60% lower risk of failure than patients with POAG (95% Confidence Interval (CI): 0.19-0.82). Patients that were on one more glaucoma medication had 1.40 times higher risk of failure than patients with one less medications (95% CI: 1.23-1.60). Diagnosis and number of medications were found to have statistically significance. Race, age, gender and visual field were not statistically significant.
Trabectome only populations were selected to identify the risk factors since Trabectome with cataract surgery had very low failures to allow identification of risk factors. Pseudoexfoliative glaucoma and low numbers of glaucoma medications are factors associated with successful outcomes in Trabectome only procedures.
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