Clinical results of Trabectome surgery for open-angle glaucoma

Figures & data

Table 1 Baseline demographics for all cases and subgroups of cases

	All cases	Subgroups		P-value
		POAG	EXG
Patients, number of eyes, (%)	78 (82)	39 (43)	39 (39)
Age, years, mean ± SD	73.3±13.0	67.4±14.1	79.7±7.5	<0.0001
Sex, n
Female	46 (48 eyes)	24 (27 eyes)	22 (22 eyes)
Male	32 (34 eyes)	15 (16 eyes)	17 (17 eyes)	0.56
Lens status, number of eyes, (%)
Phakic	19 (23.2)	12 (27.9)	7 (17.9)
Pseudophakic	63 (96.8)	31 (72.1)	32 (82.1)	0.29
Mean deviation (dB), mean ± SD	−13.9±9.2	−13.4±9.0	−14.4±9.5	0.62
Prior treatment, number of eyes, (%)
Argon laser trabeculoplasty	0	0	0
Selective laser trabeculoplasty	0	0	0
Trabeculotomy	17 (20.7)	5 (11.6)	12 (30.8)
Trabeculectomy	4 (4.9)	3 (7.0)	1 (2.6)
Pars plana vitrectomy	2 (2.4)	1 (2.3)	1 (2.6)
None	59 (72.0)	34 (79.1)	25 (64.1)

Abbreviations: POAG, primary open-angle glaucoma; EXG, exfoliation glaucoma; SD, standard deviation.

Table 2 Mean intraocular pressure of the operated eye before and after undergoing Trabectome surgery

	All cases (eyes)	Subgroup (eyes)		P-value
		POAG	EXG
Baseline	22.3±6.8 (82)	23.5±7.2 (43)	21.7±6.2 (39)	0.22
Postoperatine visit
6 months	15.4±3.3 (74)	16.2±3.4 (37)	14.5±3.0 (37)	0.02
% reduction	25.7±19.0	23.8±15.7	27.6±21.8	0.40
12 months	15.1±3.2 (60)	15.7±3.0 (29)	14.6±3.4 (31)	0.22
% reduction	24.0±19.5	22.6±16.8	24.4±22.1	0.72
18 months	14.4 ±3.3 (43)	15.3±2.4 (23)	13.3±3.9 (20)	0.03
% reduction	25.3±23.6	22.7±20.0	28.3±27.6	0.44
24 months	14.0±3.9 (22)	14.1±2.2 (8)	13.9±4.7 (14)	0.89
% reduction	23.0±25.3	23.8±20.2	21.0±28.4	0.80

Notes: Data are presented as mean ± standard deviation. The values in the parenthesis refer to the the number of the eyes.

Abbreviations: POAG, primary open-angle glaucoma; EXG, exfoliation glaucoma.

Table 3 Mean number of glaucoma medications in the operative eye before and after Trabectome surgery

	All cases (eyes)	Subgroup (eyes)		P-value
		POAG	EXG
Baseline	2.8±0.8 (82)	2.8±0.8 (43)	2.7±0.8 (39)	0.15
6 months	2.6±0.8 (75)	2.5±0.9 (37)	2.6±0.8 (38)	0.63
12 months	2.7±0.8 (62)	2.4±0.8 (29)	2.8±0.9 (33)	0.1
18 months	2.7±0.8 (46)	2.5±0.7 (23)	2.7±1.0 (23)	0.39
24 months	2.6±0.8 (24)	1.8±1.0 (8)*	2.9±0.7 (16)	0.003

Notes:

* Significant decrease in antiglaucoma medications versus baseline in patients with POAG. Data are presented as mean ± standard deviation. The values in the parenthesis refer to the the number of the eyes.

Abbreviations: POAG, primary open-angle glaucoma; EXG, exfoliation glaucoma.

Table 4 Kaplan–Meier success rate (%) for cases of Trabectome surgery

	All cases (%)	Subgroup		P-value
		POAG (%)	EXG (%)
6 months	76.8	76.7	77.0
12 months	64.1	59.4	69.2
18 months	53.6	59.4	49.2
24 months	51.2	50.9	49.2	0.91

Abbreviations: POAG, primary open-angle glaucoma; EXG, exfoliation glaucoma.

Table 5 Type and prevalence of postoperative complications following Trabectome surgery

Complication	All cases, number of eyes (%)	Sub-group		P-value
		POAG	EXG
Hyphema	19 (23.2)	14	5	0.03
Microhyphema	63 (76.8)	29	34	0.03
IOP spike >10 mmHg	4 (4.9)	1	3	0.26
VA decrease >2 lines	1 (1.2)	1	0	0.34
Cataract progression	1 (1.2)	1	0	0.34

Abbreviations: IOP, intraocular pressure; VA, visual acuity; POAG, primary open-angle glaucoma; EXG, exfoliation glaucoma.

Table 6 Univariate logistic regression and multivariate logistic regression of failed Trabectome surgery in the treatment of open-angle glaucoma

Parameter	Category	Number of eyes	Failure eye, number of eyes (%)	Univariate logistic regression			Multivariate logistic regression (Backward elimination: P<0.05)
				OR	95% CI	P-value	OR	95% CI	P-value
Eye		82	35 (42.7)
Sex	Male	34	13 (38.2)	Reference
	Female	48	22 (45.8)	1.367	(0.559, 3.345)	0.494
Age, years	<68	19	8 (42.1)	Reference		0.886
	68≤ ~ <77	20	10 (50.0)	1.375	(0.388, 4.867)	0.621
	77≤ ~ <82	22	9 (40.9)	0.952	(0.274, 3.308)	0.938
	82≤	21	8 (38.1)	0.846	(0.238, 3.004)	0.796
Open-angle glaucoma type	EXG	39	16 (41.0)	Reference
	POAG	43	19 (44.2)	1.138	(0.473, 2.736)	0.773
Prior glaucoma surgery	(−)	57	20 (35.1)	Reference
	(+)	25	15 (60.0)	2.775	(1.055, 7.302)	0.039
Mean deviation, dB	<−22.2	19	9 (47.4)	Reference		0.682
	−22.2≤ ~ <−12.3	19	7 (36.8)	0.648	(0.177, 2.369)	0.512
	−12.3≤ ~ <−6.5	18	9 (50.0)	1.111	(0.306, 4.037)	0.873
	≤−6.5	20	9 (45.0)	0.909	(0.258, 3.204)	0.882
	None	6	1 (16.7)	0.222	(0.022, 2.280)	0.205
Lens status	Pseudophakic	63	26 (41.3)	Reference
	Phakic	19	9 (47.4)	1.281	(0.457, 3.590)	0.638
Baseline IOP, mmHg	<18	17	12 (70.6)	Reference		0.042	Reference		0.026
	18≤ ~ <22	22	5 (22.7)	0.123	(0.029, 0.519)	0.004	0.123	(0.029, 0.519)	0.004
	22≤ ~ <28	21	9 (42.9)	0.313	(0.081, 1.211)	0.092	0.284	(0.072, 1.117)	0.072
	28≤	22	9 (40.9)	0.288	(0.075, 1.108)	0.070	0.168	(0.039, 0.732)
Baseline medications (n)	1, 2, 3	76	30 (39.5)	Reference			Reference		0.019
	4, 5	6	5 (83.3)	7.666	(0.853, 68.887)	0.069	11.493	(1.107, 119.324)	0.020

Note: Failure eye was defined as treatment failure if the success criterion was not met at two consecutive visits after 3 postoperative months.

Abbreviations: IOP, intraocular pressure; OR, odds ratio; CI, confidence interval; POAG, primary open-angle glaucoma; EXG, exfoliation glaucoma.