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

  • Glaucoma
  • Published:
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Abstract

Purpose

To analyze the 5-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 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).

Results

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.

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.

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Funding

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.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, School of Medicine, University of Pittsburgh, 203 Lothrop St, Suite 819, Pittsburgh, PA, 15213, USA

    Hamed Esfandiari, Priyal Shah, Ian P. Conner & Nils A. Loewen

  2. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Pooya Torkian & Kiana Hassanpour

  3. Department of Ophthalmology, School of Medicine, New York University, NY, New York City, USA

    Joel S. Schuman

Authors
  1. Hamed Esfandiari
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  2. Priyal Shah
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  3. Pooya Torkian
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  4. Ian P. Conner
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  5. Joel S. Schuman
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  6. Kiana Hassanpour
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  7. Nils A. Loewen
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Corresponding author

Correspondence to Nils A. Loewen.

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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.

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For this type of study formal consent was not required.

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Esfandiari, H., Shah, P., Torkian, P. et al. Five-year clinical outcomes of combined phacoemulsification and trabectome surgery at a single glaucoma center. Graefes Arch Clin Exp Ophthalmol 257, 357–362 (2019). https://doi.org/10.1007/s00417-018-4146-y

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  • DOI: https://doi.org/10.1007/s00417-018-4146-y

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