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Long-term clinical results of trabectome surgery in patients with open-angle glaucoma

  • Glaucoma
  • Published:
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Abstract

Purpose

To evaluate the 72-month clinical results of trabectome surgery (TOM) in patients with primary open-angle glaucoma (POAG), secondary OAG and childhood glaucoma.

Method

A total of 305 eyes from 249 glaucoma patients were analyzed in the current retrospective single-center study. Kaplan-Meier analysis was performed using three criteria: criterion A (postoperative intraocular pressure [IOP] ≤ 21 mmHg and ≥ 20% reduction from baseline IOP); criterion B (postoperative IOP ≤ 18 mmHg and ≥ 20% reduction from baseline IOP); and criterion C (postoperative IOP ≤ 16 mmHg and ≥ 20% reduction from baseline IOP). The changes in IOP, medication score, success probability, results of the multivariate analysis for success and failure risk factors, and complications were analyzed.

Results

The baseline IOP in all glaucoma patients decreased from 29.2 ± 9.8 mmHg with a 5.3 ± 1.7 medication score to 16.4 ± 5.8 mmHg (− 43.8%) with a 4.2 ± 1.5 medication score at 72 months (p < 0.01). The success probabilities in all cases for 72 months based on criterion A, B, and C were 44%, 35%, and 17%, respectively. For criterion A, no significant differences were found in the success probability according to the glaucoma subtype for 72 months. The combined surgical procedure significantly decreased the failure risk (hazard ratio [HR]: 0.59). On the other hand, the presence of POAG (HR: 1.6) and a history of past selective laser trabeculoplasty (HR: 2.2) significantly increased failure risk. One patient (0.3%) demonstrated endophthalmitis after TOM but recovered through appropriate treatment.

Conclusion

At the 72-month time point, approximately half of the glaucoma patients maintained an IOP ≤ 21 mmHg with ≥ 20% IOP reduction. TOM is a safe surgery but may not yield sufficient IOP reduction in patients who have received SLT or have POAG.

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Funding

This study was supported by a research fund at Kitasato University.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan

    Yusuke Kono, Tatsuhiko Tsujisawa, Shunsuke Kanayama & Nobuyuki Shoji

  2. Department of Ophthalmology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan

    Masayuki Kasahara, Kazunori Hirasawa, Kazuhiro Matsumura, Tetsuya Morita & Nobuyuki Shoji

  3. Machida Matsumura Eye Clinic, Tokyo, Japan

    Kazuhiro Matsumura

  4. Morita Eye Clinic, Tokyo, Japan

    Tetsuya Morita

Authors
  1. Yusuke Kono
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  2. Masayuki Kasahara
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  3. Kazunori Hirasawa
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  4. Tatsuhiko Tsujisawa
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  5. Shunsuke Kanayama
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  6. Kazuhiro Matsumura
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  7. Tetsuya Morita
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  8. Nobuyuki Shoji
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Nobuyuki Shoji, Tetsuya Morita, Kazuhiro Matsumura, and Masayuki Kasahara. The first draft of the manuscript was written by Yusuke Kono, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nobuyuki Shoji.

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The authors declare that they have no conflict of interest.

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This study was approved by the Institutional Review Board of Kitasato University.

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Informed consent was obtained from all participants.

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Kono, Y., Kasahara, M., Hirasawa, K. et al. Long-term clinical results of trabectome surgery in patients with open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 258, 2467–2476 (2020). https://doi.org/10.1007/s00417-020-04897-0

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  • DOI: https://doi.org/10.1007/s00417-020-04897-0

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