Five-year clinical outcomes of combined phacoemulsification and trabectome surgery at a single glaucoma center

  • Hamed Esfandiari
  • Priyal Shah
  • Pooya Torkian
  • Ian P. Conner
  • Joel S. Schuman
  • Kiana Hassanpour
  • Nils A. LoewenEmail author



To analyze the 5-year results of trabectome ab interno trabeculectomy of a single glaucoma center.


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).


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.


Trabectome surgery was associated with a good long-term efficacy and safety profile in this single-center case series with a high retention rate.


Ab interno trabeculectomy Trabectome surgery Long-term outcomes Microinvasive glaucoma surgeries MIGS 



This study received financial support from The Initiative to Cure Glaucoma, The Eye and Ear Foundation of Pittsburgh, NIH CORE Grant P30 EY08098 to the Department of Ophthalmology, and from an unrestricted grant from Research to Prevent Blindness, New York, NY.

Compliance with ethical standards

Conflict of interest

NAL has received honoraria for trabectome wet labs and lectures from Neomedix Corp.

Ethical approval/ethics statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement of informed consent

For this type of study formal consent was not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Ophthalmology, School of MedicineUniversity of PittsburghPittsburghUSA
  2. 2.Ophthalmic Research CenterShahid Beheshti University of Medical SciencesTehranIran
  3. 3.Department of Ophthalmology, School of MedicineNew York UniversityNYUSA

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