Glaucoma Tube or Trabeculectomy? That Is the Question

Jamil, Annisa L.; Mills, Richard P.

doi:10.1016/j.ajo.2006.10.024

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…It has been argued that hypotony may be an acceptable outcome of glaucoma surgery if it is not associated with vision loss. 42 It is noteworthy that the vast majority of patients who failed because of persistent hypotony in the TVT Study also had associated vision loss, and the study results did not significantly change when the 3 patients with hypotony and stable vision were reclassified as successes instead of failures. Several baseline factors were examined as possible risk factors for treatment failure, and only treatment assignment predicted treatment outcome.…”

Section: Discussionmentioning

confidence: 82%

Treatment Outcomes in the Tube Versus Trabeculectomy (TVT) Study After Five Years of Follow-up

Gedde

Schiffman

Feuer

et al. 2012

American Journal of Ophthalmology

907

678

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Section: Discussionmentioning

confidence: 82%

Treatment Outcomes in the Tube Versus Trabeculectomy (TVT) Study After Five Years of Follow-up

Gedde

Schiffman

Feuer

et al. 2012

American Journal of Ophthalmology

907

678

View full text Add to dashboard Cite

show abstract

“…Surgical success in this study was defined as a sufficient IOP reduction, no serious complications and no significant hypotony. Hypotony criteria may not be an appropriate indicator for surgical failure since patients with postoperative IOP in hypotony ranges are often visually asymptomatic [ 38 ]. However, the guidelines of the World Glaucoma Association recommend setting a lower IOP limit (i.e.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes and Prognostic Factors of Trabeculectomy following Intraocular Bevacizumab Injection for Neovascular Glaucoma

2015

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PurposeTo evaluate long-term outcomes and identify prognostic factors of trabeculectomy following intraocular bevacizumab injection for neovascular glaucoma.MethodsSixty-one eyes of 54 patients with neovascular glaucoma treated by trabeculectomy following intraocular bevacizumab injection were consecutively enrolled. Surgical success criteria were sufficient intraocular pressure (IOP) reduction (IOP ≤21 mmHg, ≥20% IOP reduction, no additional medications or glaucoma surgeries) without devastating complications (loss of light perception, phthisis bulbi, and endophthalmitis) or significant hypotony (IOP ≤5 mmHg continued ≥6 months and until the last follow-up visit or hypotony requiring intervention). Kaplan-Meier survival curves and Cox regression analysis were used to examine success rates and risk factors for surgical outcomes.ResultsThe follow-up period after trabeculectomy was 45.0 ± 22.2 months (mean ± standard deviation). Surgical success rate was 86.9 ± 4.3% (± standard error), 74.0 ± 6.1%, and 51.3 ± 8.6% at 1, 3, and 5 years. Multivariate Cox regression analysis identified two risk factors; lower preoperative IOP (≤30 mmHg) for surgical failure and hypotony [hazard ratio (HR), 2.92, 6.64; 95% confidence interval (CI), 1.22 to 7.03, 1.47 to 30.0; P = 0.018, 0.014, respectively], and vitrectomy after trabeculectomy for surgical failure with or without hypotony criteria (HR, 2.32, 4.06; 95% CI, 1.02 to 5.28, 1.30 to 12.7; P = 0.045, 0.016, respectively).ConclusionsThe long-term outcomes of trabeculectomy following intraocular bevacizumab injection for neovascular glaucoma were favorable. Lower baseline IOP was associated with development of significant hypotony, while additional vitrectomy was related to insufficient IOP reduction.

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“…4,5 When elevated IOP cannot be controlled phar-macologically, IOP-lowering surgery is usually performed. 6,7 Intraocular pressurelowering surgical options include trabeculectomy, which can be performed in a variety of ways, 8 and the placement of glaucoma drainage devices. 9,10 Selective laser trabeculoplasty has also been used in a small case series of patients.…”

Section: T He Incidence Of Uveitis Inmentioning

confidence: 99%

Intraocular Pressure in Patients With Uveitis Treated With Fluocinolone Acetonide Implants

et al. 2007

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To report the incidence and management of elevated intraocular pressure (IOP) in patients with uveitis treated with the fluocinolone acetonide (FA) intravitreal implant. Design: Pooled data from 3 multicenter, doublemasked, randomized, controlled, phase 2b/3 clinical trials evaluating the safety and efficacy of the 0.59-mg or 2.1-mg FA intravitreal implant or standard therapy were analyzed. Results: During the 3-year follow-up, 71.0% of implanted eyes had an IOP increase of 10 mm Hg or more than baseline and 55.1%, 24.7%, and 6.2% of eyes reached an IOP of 30 mm Hg or more, 40 mm Hg or more, and 50 mm Hg or more, respectively. Topical IOP-lowering medication was administered in 74.8% of implanted eyes, and IOP-lowering surgeries, most of which were trabeculectomies (76.2%), were performed on 36.6% of implanted eyes. Intraocular pressure-loweringsurgerieswereconsideredasuccess(postoperative IOP of 6-21 mm Hg with or without additional IOP-lowering medication) in 85.1% of eyes at 1 year. The rate of hypotony (IOPՅ5 mm Hg) following IOP-lowering surgery (42.5%) was not different from that of implanted eyes not subjected to surgery (35.4%) (P=.09). Conclusion: Elevated IOP is a significant complication with the FA intravitreal implant but may be controlled with medication and surgery.

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Glaucoma Tube or Trabeculectomy? That Is the Question

Cited by 10 publications

References 9 publications

Treatment Outcomes in the Tube Versus Trabeculectomy (TVT) Study After Five Years of Follow-up

Treatment Outcomes in the Tube Versus Trabeculectomy (TVT) Study After Five Years of Follow-up

Long-Term Outcomes and Prognostic Factors of Trabeculectomy following Intraocular Bevacizumab Injection for Neovascular Glaucoma

Intraocular Pressure in Patients With Uveitis Treated With Fluocinolone Acetonide Implants

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