Three-Year Follow-up of the Tube Versus Trabeculectomy Study

Gedde, Steven J.; Schiffman, Joyce C.; Feuer, William J.; Herndon, Leon W.; Brandt, James D.; Budenz, Donald L.

doi:10.1016/j.ajo.2009.06.018

Cited by 344 publications

(280 citation statements)

References 47 publications

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“…[28][29][30][31] The mean IOP was B13 mm Hg at 3 years in both, the trabeculectomy and tube groups, similar to that of DS in our study. Complete (medication-free) success rates at 3 years were much lower than our study.…”

Section: Discussionsupporting

confidence: 83%

“…31 This may be interpreted with some caution because of the retrospective nature of our study. On the other hand, mean follow-up was about 5 years, increasing the probability of observing delayed complications like bleb leak, bleb-related infections and dysaesthesia and ocular hypotony.…”

Section: Eyementioning

confidence: 90%

“…The Tube versus Trabeculectomy (TVT) trial was designed to prospectively assess trabeculectomy and Bearveldt tube implant (BGI) surgery, both augmented with MMC, in eyes with previous cataract surgery and/or failed trabeculectomy. [28][29][30][31] The study suggests that better IOP outcomes are achieved after BGI compared with trabeculectomy at 3 years. However, eyes with tube surgery may be prone to more serious long-term complications like corneal decompensation and diplopia.…”

Section: Introductionmentioning

confidence: 89%

“…32 Failure was defined as IOP 421 mm Hg or o20% reduction below baseline on two consecutive follow-up visits after 3 months. IOP o5 mm Hg on two consecutive follow-up visits after 3 months, reoperation for glaucoma, or loss of light perception vision were considered as failure.…”

Section: Methodsmentioning

confidence: 99%

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Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

Anand

Wechsler²

2011

Eye

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Purpose To report outcomes of deep sclerectomy (DS) with intraoperative mitomycin C (MMC) application in eyes with previous failed glaucoma surgery (GS) and/or cataract extraction (CE). Patients and methods Single-surgeon case series of 82 eyes of 82 patients undergoing DS with MMC. The patients had previous CE with IOL and/or conjunctival GS and treated intraocular pressure (IOP) 418 mm Hg. MMC (0.2 mg/ml) was applied for 2-3 min before scleral flap dissection. Complete success was defined as IOP between 6 and 21 mm Hg or a reduction of 20% from baseline without medications. Reoperation for glaucoma or related complications, or loss of light perception vision was considered as failure. Results Mean follow-up was 57.7±22.4 months with 78% of patients completing the 3-year follow-up. Mean IOP decreased from 24.0 mm Hg (22.3-25.6, 95% confidence intervals) to 13.4 mm Hg (12.0-14.2) at 3 years after surgery (Po0.001). There was a significant decrease in the number of glaucoma medications from 2.0±1 preoperatively, to 0.3±0.7, 3 years after surgery. Kaplan-Meier cumulative success rates were 85.6% at 1 year, 80.0% at 2 years, and 76% at 3 years. At 3 years, IOP was maintained o19 and 15 mm Hg in 83 and 70% of eyes, respectively. Fourteen eyes (17.1%) had complications. Delayed hypotony (IOP o6 mm Hg) was the commonest complication in five eyes (6.1%). Conclusion DS with MMC appears to be a safe and effective surgical procedure for eyes with previous intraocular surgery.

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Section: Discussionsupporting

confidence: 83%

Section: Eyementioning

confidence: 90%

Section: Introductionmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

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Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

Anand

Wechsler²

2011

Eye

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“…Moreover, our patients underwent NPDS surgery, which generally produces a lower IOP reduction compared with trabeculectomy or tube shunt implantation. [17][18][19] This suggests that the LC displacement is associated with larger IOP reductions, whereas milder changes primarily affect the prelaminar tissue. However, Lee et al also included 12 patients who had preoperative IOPs within the normal range (18.2 mm Hg), and they found significant cupping reversal and anterior displacement of the LC.…”

Section: Discussionmentioning

confidence: 99%

Changes in lamina cribrosa and prelaminar tissue after deep sclerectomy

Barrancos

Rebolleda

Oblanca

et al. 2013

Eye

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Aim To determine the response of the lamina cribrosa (LC) and prelaminar tissue to a reduction of intraocular pressure (IOP) after nonpenetrating deep sclerectomy (NPDS) using enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT). Methods A total of 28 eyes from 28 patients presenting with primary open angle glaucoma who underwent NPDS were studied. SD-OCT scans using EDI technology were obtained before surgery and 1 week, 1 month, and 3 months postoperatively. The OCT device was set to image a 15 Â 101 vertical rectangle centred on the optic disc. The scan closest to the optic nerve head (ONH) centre was selected for analysis. The vertical distances from three equidistant points on the reference line (Bruch's membrane opening) to the anterior prelaminar tissue surface and the anterior and posterior surfaces of the LC were measured. Results The IOP decreased from 18.7 ± 4.3 to 9.1±4.0 at the first week, 11.4±3.7 at 1 month, and 13.1±3.6 mm Hg at 3 months postoperatively (Po0.001). There was a significant reduction of the ONH cupping at 1 week (22.3%, Po0.001), 1 month (13.7%, Po0.001), and 3 months (9.8%, P ¼ 0.001) after surgery. Anterior displacement of the LC was slight but statistically significant at 1 week (4.5%, P ¼ 0.003), 1 month (3.8%, P ¼ 0.014), and 3 months postoperatively (3.3%, P ¼ 0.010). IOP reduction was significantly correlated with a reduction of ONH cupping and anterior displacement of LC at the first week and first month (Po0.05). Conclusions Cupping reversal after NPDS is mainly due to changes in prelaminar tissue thickness, whereas the LC changes in position are less pronounced.

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Otago Glaucoma Surgery Outcome Study

Thompson¹,

Molteno²,

Bevin³

et al. 2013

JAMA Ophthalmol

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To evaluate the efficacy of the 175-mm 2 Molteno3 implant in patients with nonneovascular glaucoma.Methods: A hospital-based, retrospective historical control comparative case series comparing results in the first 87 eyes to receive the 175-mm 2 Molteno3 implant with those in a control group of 115 eyes receiving the 274mm 2 double-plate Molteno implant.Results: Successwasdefinedasanintraocularpressure(IOP) of at least 6 mm Hg but not more than 21 mm Hg with or without hypotensive medication. The mean postoperative follow-up was 3.0 years (range, 13 days to 5.6 years) in the Molteno3 implant group and 6.2 years (range, 1 day to 13.9 years) in the double-plate Molteno implant group. The mean (SD) preoperative IOP was 25.6 (7.1) mm Hg in the Mol-teno3 implant group in eyes treated with a mean of 2.3 ocular hypotensive medications, and 25.7 (8.0) mm Hg in the double-plate Molteno implant group in eyes treated with a mean of 2.2 medications. The mean (SD) postoperative IOP at 36 months was 13.9 (3.2) mm Hg in the Molteno3 implant group in eyes treated with a mean of 0.9 ocular hypotensive medications, and 14.5 (3.4) mm Hg in the doubleplate group in eyes treated with a mean of 0.7 medications. The probability of IOP control at 3 years was 0.79 in both groups.Therewassignificantlymorepostoperativehypotony in eyes without a polyglactin 910 tie in the Molteno3 implant group (P=.04); however, significantly more eyes with flat anterior chambers in the double-plate group required anterior chamber reformation (P=.03). Conclusion:The 175-mm 2 Molteno3 implant provided intermediate-term successful treatment of nonneovascular glaucoma comparable to that provided by the double-plate Molteno implant.

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Three-Year Follow-up of the Tube Versus Trabeculectomy Study

Cited by 344 publications

References 47 publications

Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

Changes in lamina cribrosa and prelaminar tissue after deep sclerectomy

Otago Glaucoma Surgery Outcome Study

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