Abstract
Purpose:
To evaluate the safety and efficacy of Trabectome after failed glaucoma drainage device surgery.
Methods:
24 patients with prior failed tube shunt surgery that underwent Trabectome alone or Trabectome combined with phacoemulsification procedures were included in this study. All patients had at least three months of follow-up postoperatively. Outcomes measured included intraocular pressure (IOP), number of glaucoma medications, and secondary glaucoma surgeries if any. The success for Kaplan Meier survival analysis is defined as IOP < 21 mmHg, IOP reduced by at least 20% from preoperative IOP, and no secondary glaucoma surgery.
Results:
Preoperatively, the mean IOP was 23.0 ± 6.5 mmHg and mean number of glaucoma medications was 3.2 ± 1.4. At 12 months postoperatively, IOP was reduced to 16.1 ± 4.9 mmHg (p=0.02) and number of medications was reduced to 2.4 ± 1.5 (p=0.34). The survival rate at 12 months was 83%, with three patients requiring additional glaucoma surgery. Fifteen patients reached 12 months of follow-up. Two patients had hypotony at day one, but quickly resolved.
Conclusions:
Trabectome was safe and effective in reducing IOP at one year follow-up in patients with prior failed glaucoma device drainage surgery, but was not effective in reducing medication reliance in these patients.
Keywords: 568 intraocular pressure •
735 trabecular meshwork •
633 outflow: trabecular meshwork