The Outcomes of Trabectome Surgery in Patients with Low, Middle, and High Preoperative Intraocular Pressure

• Main Authors: Tojo N, Hayashi A
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-11-01
• Series: Clinical Ophthalmology
• Subjects: trabectome; surgical outcome; intraocular pressure; factor; preoperative iop
• Online Access: https://www.dovepress.com/the-outcomes-of-trabectome-surgery-in-patients-with-low-middle-and-hig-peer-reviewed-article-OPTH

Naoki Tojo, Atsushi Hayashi Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, JapanCorrespondence: Atsushi HayashiDepartment of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanTel [phone]Fax [phone]Email [e-mail]: We compared the efficiency of trabectome surgery for patients with differing preoperative intraocular pressure (IOP) values in a single-facility retrospective study. We evaluated surgical outcomes based on three grades of preoperative IOP: high (hi-IOP, > 26 mmHg), middle (mid-IOP, 18– 26 mmHg), and low (lo-IOP, < 18 mmHg).Patients and Methods: We analyzed the cases of 204 eyes that underwent trabectome surgery and were followed > 2 years. We defined failure as a reduction of IOP < 20% or requiring additional glaucoma surgery. We used 4 cutoff values > 21, > 18, > 15, and > 12 mmHg. Other factors that may affect surgical outcomes were also investigated: age, central corneal thickness (CCT), history of selective laser trabeculotrabculoplasty (SLT), preoperative visual field, and simultaneous cataract surgery.Results: Trabectome surgeries significantly decreased the IOP values from 23.0 ±  7.2 mmHg to 13.6 ±  3.6 mmHg at 2 years post-surgery. The mid-IOP group achieved significantly better surgical outcomes than the lo-IOP and hi-IOP groups with cutoff values 21, 18, and 15 mmHg. A thin CCT and simultaneous cataract surgery were significantly related to better surgical outcomes with cutoff value 21.18 and 15 mmHg.Conclusion: For the patients with preoperative IOP < 18 mmHg, it was difficult to decrease their IOP > 20% with trabectome surgery. Patients with preoperative IOP values > 26 mmHg often required additional glaucoma surgery.Keywords: trabectome, surgical outcome, intraocular pressure, factor, preoperative IOP