Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Five-Year Clinical Outcomes of Trabectome Surgery at a Single Glaucoma Center

Version 1 : Received: 18 April 2018 / Approved: 19 April 2018 / Online: 19 April 2018 (09:41:02 CEST)

How to cite: Esfandiari, H.; Shah, P.; Torkian, P.; Conner, I.P.; Schuman, J.S.; Hassanpour, K.; Loewen, N.A. Five-Year Clinical Outcomes of Trabectome Surgery at a Single Glaucoma Center. Preprints 2018, 2018040248. https://doi.org/10.20944/preprints201804.0248.v1 Esfandiari, H.; Shah, P.; Torkian, P.; Conner, I.P.; Schuman, J.S.; Hassanpour, K.; Loewen, N.A. Five-Year Clinical Outcomes of Trabectome Surgery at a Single Glaucoma Center. Preprints 2018, 2018040248. https://doi.org/10.20944/preprints201804.0248.v1

Abstract

Purpose: To analyze the five-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 mm Hg, or >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 five years 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). Pseudoexfoliation 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. A higher baseline IOP, older age, thinner cornea, and pseudoexfoliation glaucoma were associated with a higher success rate.

Keywords

Ab interno trabeculectomy; Trabectome surgery; long-term outcomes; microinvasive glaucoma surgeries; MIGS

Subject

Medicine and Pharmacology, Ophthalmology

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