Preprint Article Version 1 This version is not peer-reviewed

Coarsened Exact Matching of Trabectome Surgery Combined with Baerveldt to Baerveldt: Same Session Trabectome Negates Tube Fenestration

Version 1 : Received: 6 November 2018 / Approved: 8 November 2018 / Online: 8 November 2018 (11:26:26 UTC)

How to cite: Esfandiari, H.; Hassanpour, K..; Knowlton, P..; Shazly, T..; Yaseri, M.; Loewen, N.A. Coarsened Exact Matching of Trabectome Surgery Combined with Baerveldt to Baerveldt: Same Session Trabectome Negates Tube Fenestration. Preprints 2018, 2018110211 (doi: 10.20944/preprints201811.0211.v1). Esfandiari, H.; Hassanpour, K..; Knowlton, P..; Shazly, T..; Yaseri, M.; Loewen, N.A. Coarsened Exact Matching of Trabectome Surgery Combined with Baerveldt to Baerveldt: Same Session Trabectome Negates Tube Fenestration. Preprints 2018, 2018110211 (doi: 10.20944/preprints201811.0211.v1).

Abstract

Purpose: To evaluate the efficacy and survival rates of trabectome-mediated ab interno trabeculectomy combined with non-fenestrated Baerveldt glaucoma implants (BT) in comparison to Baerveldt glaucoma implant alone (B).Method: A total of 175 eyes undergoing primary glaucoma surgery (60 eyes BT and 115 B) were enrolled in this retrospective comparative case series. Participants were identified using the procedural terminology codes. Groups were then matched using Coarsened Exact Matching (51 eyes in each group). The primary outcome measure was surgical success, defined as 5 mmHg < IOP ≤ 21 mmHg, and IOP reduction ≥ 20% from baseline, and no reoperation for glaucoma. Secondary outcome measures were intraocular pressure, the number of glaucoma medications, and best corrected visual acuity (BCVA).Results: The cumulative probability of success at one year was 61% in BT, and 50% in B. IOP decreased significantly from 23.5±2.4 mmHg at baseline to 14.1±2.7 mmHg at the final follow up in BT (P= 0.001). The corresponding numbers for B were 23.2± 2.0 and 13.9± 1.6, respectively (P= 0.001). There was no significant difference in IOP at the final follow-up (P=0.56). The number of medications at baseline was 2.3±0.3 in both groups. However, BT needed significantly fewer drops at all postoperative time intervals and used 1.1±0.3 (BT) and 2.0±0.4 eye drops (B) at the final follow-up visit (P= 0.004). No dangerous hypotony or hypertension occurred in BT.Conclusion: Similar rates of success and IOP reduction were observed in BT and B. BT needed significantly fewer glaucoma medications. Tube fenestration was not necessary in BT resulting in less postoperative hypotony and hypertension.

Subject Areas

Trabectome Surgery, ab interno trabeculectomy, glaucoma drainage devices, Baerveldt Glaucoma Implantation, tube ligation

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