1. Five-year clinical outcomes of combined phacoemulsification and trabectome surgery at a single glaucoma center
- Author
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Pooya Torkian, Nils A. Loewen, Priyal Shah, Kiana Hassanpour, Joel S. Schuman, Ian P. Conner, and Hamed Esfandiari
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Intraocular pressure ,Time Factors ,genetic structures ,medicine.medical_treatment ,Visual Acuity ,Glaucoma ,Trabeculectomy ,Cataract ,Article ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,medicine ,Glaucoma surgery ,Humans ,Trabectome ,Intraocular Pressure ,Aged ,Phacoemulsification ,Proportional hazards model ,business.industry ,medicine.disease ,Trabeculotomy ,Sensory Systems ,Surgery ,Ophthalmology ,Treatment Outcome ,030104 developmental biology ,030221 ophthalmology & optometry ,Female ,business ,Glaucoma, Open-Angle ,Follow-Up Studies - Abstract
PURPOSE: To analyze the 5-year results of trabectome ab interno trabeculectomy of a single glaucoma center. METHOD: In this retrospective interventional single-center case series, data of 93 patients undergoing ab interno trabeculotomy between September 2010, and December 2012 were included. Kaplan-Meier analysis was performed using success criteria defined as postoperative intraocular pressure (IOP) ≤ 21 mmHg, and > 20% reduction from preoperative IOP, and no need for further glaucoma surgery. Risk factors for failure were identified using Cox proportional hazards ratio (HR). RESULTS: The retention rate for 5-year follow-up was 66%. The cumulative probability of success at 1, 2, 3, 4, and 5 years was 82.6%, 76.7%, 73.9%, 72.3%, and 67.5%. Risk factors for failure were lower baseline IOP (HR = 0.27, P = 0.001), younger age (HR = 0.25, P = 0.02), and higher central corneal thickness (HR = 0.18, P = 0.01). Exfoliative glaucoma was associated with a higher success rate (HR = 0.39, P = 0.02). IOP was decreased significantly from 20.0 ± 5.6 mmHg at baseline to 15.6 ± 4.6 mmHg at 5-year follow-up (P = 0.001). The baseline number of glaucoma medications was 1.8 ± 1.2, which decreased to 1.0 ± 1.2 medications at 5 years. CONCLUSION: Trabectome surgery was associated with a good long-term efficacy and safety profile in this single-center case series with a high retention rate.
- Published
- 2018