Outcomes of ab interno trabeculectomy with the trabectome after failed trabeculectomy. Issue 2 (28th August 2014)

• Record Type: Journal Article
• Authors: Bussel, I I; Kaplowitz, K; Schuman, J S; Loewen, N A
• Is Part Of: British journal of ophthalmology. Volume 99:Issue 2(2015)
• Page Start: 258
• Page End: 262
• Publication Date: 2014-08-28
• Subjects: Glaucoma -- Treatment Surgery; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2013-304717
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Aim: To evaluate outcomes of ab interno trabeculectomy (AIT) with the trabectome following failed trabeculectomy. Methods: Prospective study of AITs and phaco-AITs after a failed trabeculectomy. The indication for AIT was intraocular pressure (IOP) above target on maximally tolerated therapy, and for phaco-AIT a visually significant cataract and need to lower IOP or glaucoma medications. Outcomes included IOP, medications, complications, secondary procedures and success, defined as IOP of less than 21 mm Hg and a greater than 20% reduction from baseline without further surgery. Exclusion criteria were trabeculectomy less than 3 months prior to AIT or follow-up under 1 year. Results: Seventy-three eyes of 73 patients with 1 year follow-up were identified. At 1 year, mean IOP in AIT significantly decreased by 28% from 23.7±5.5 mm Hg, and medications from 2.8±1.2 to 2±1.3 (n=58). In phaco-AIT, the mean IOP decreased 19% from 20±5.9 mm Hg and medications from 2.5±1.5 to 1.6±1.4 (n=15). Transient hypotony occurred in 7%, and further surgery was necessary in 18%. For AIT and phaco-AIT, the 1-year cumulative probability of success was 81% and 87%, respectively. Conclusions: Both AIT and phaco-AIT showed a reduction in IOP and medication use after 1 year, suggesting that AIT with or without cataract surgery is a safe and effective option following failed trabeculectomy.