Journal of Current Glaucoma Practice

Register      Login

VOLUME 12 , ISSUE 3 ( September-December, 2018 ) > List of Articles

RESEARCH ARTICLE

Long-term Effectiveness of Trabectome (Ab-interno Trabeculectomy) Surgery

Rick E Bendel, Michael T Patterson

Keywords : Intraocular pressure, Minimally invasive glaucoma surgery, Trabectome, Trabeculectomy, Retrospective chart review

Citation Information : Bendel RE, Patterson MT. Long-term Effectiveness of Trabectome (Ab-interno Trabeculectomy) Surgery. J Curr Glaucoma Pract 2018; 12 (3):119-124.

DOI: 10.5005/jp-journals-10078-1235

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To evaluate the long-term safety and efficacy of ab-interno trabeculectomy with trabectome for the treatment of glaucoma. Materials and methods: Data collected for 339 eyes which included demographics, intraocular pressure (IOP) measurements using Goldmann applanation tonometry, best-corrected visual acuity (BCVA), visual field results, optic nerve status, gonioscopic findings, prior glaucoma procedures, number of glaucoma medications and pain level. The main data points of interest were preoperative IOP vs. postoperative IOP and BCVA, medication use, pain status, and complications. Results: Of the 339 eyes that underwent trabectome, we found a statistically significant reduction in IOP (p < 0.01) at final follow-up (average = 18.35 months) of nearly 23%, with a complication rate of 5.86%. Furthermore, this reduction was maintained up to 8 years post procedure. LogMAR visual acuity was significantly improved in 69% of eyes at the final visit (p < 0.05), while only 1.77% of cases saw a significant reduction. Based on these findings, we determined a success rate of around 80% to 100 months following trabectome. Conclusion: Trabectome is a safe and effective long term for most forms and severities of glaucoma.


PDF Share
  1. Kingman S. Glaucoma is second leading cause of blindness globally. Bulletin of the World Health Organization. 2004;82:887-888.
  2. Resnikoff S, Pascolini D, Etya'Ale D, et al. Global data on visual impairment in the year 2002. Bulletin of the world health organization. 2004;82:844-851.
  3. Bussel II, Kaplowitz K, Schuman JS, et al. Outcomes of ab interno trabeculectomy with the trabectome after failed trabeculectomy. British Journal of Ophthalmology. 2015 Feb 1;99(2):258-262.
  4. Osman EA, AlMobarak F. Ciliochoroidal effusion with persistent hypotony after trabectome surgery. Indian Journal of Ophthalmology. 2015;63(3):272-274.
  5. Bussel II, Kaplowitz K, Schuman JS, et al. Outcomes of ab interno trabeculectomy with the trabectome by degree of angle opening. The British Journal of Ophthalmology. 2015;99(7):914-919.
  6. Minckler D, Mosaed S, Dustin L, et al. Trabectome (Trabeculectomy—Internal Approach): Addit ional Experience and Extended Follow-Up. Transactions of the American Ophthalmological Society. 2008;106:149-160.
  7. Brandão LM, Grieshaber MC. Update on Minimally Invasive Glaucoma Surgery (MIGS) and New Implants. Journal of Ophthalmology. 2013;2013:705915.
  8. Wecker T, Neuburger M, Bryniok L, et al. Ab Interno Trabeculectomy With the Trabectome as a Valuable Therapeutic Option for Failed Filtering Blebs. J Glaucoma. 2016 Sep;25(9):758-762.
  9. Okeke CO, Miller-Ellis E, Rojas M. Trabectome Study Group. Trabectome success factors. Medicine (Baltimore). 2017 Jun;96(24): e7061.
  10. Chow JTY, Hutnik CML, Solo K, et al. When Is Evidence Enough Evidence? A Systematic Review and Meta-Analysis of the Trabectome as a Solo Procedure in Patients with Primary Open-Angle Glaucoma. J Ophthalmol. 2017;2017:2965725.
  11. Vold SD. Ab interno trabeculotomy with the trabectome system: what does the data tell us? Int Ophthalmol Clin. 2011 Summer;51(3):65-81.
  12. Ngai P, Kim G, Chak G, et al. Outcome of primary trabeculotomy ab interno (Trabectome) surgery in patients with steroid-induced glaucoma. Medicine (Baltimore). 2016 Dec;95(50): e5383.
  13. Huang P, Wang H, Wu H, et al. Preliminary investigation on the safety and efficancy of Trabectome. Dept. of Ophthalmology, Peking Univ. 2015;51(2)115-119.
  14. Maeda M, Watanabe M, Ichikawa K. Evaluation of trabectome in open-angle glaucoma. International Journal of Glaucoma. 2013;22:205-208.
  15. Liu J, Jung J, Francis BA. Ab interno trabeculotomy: Trabectome TM surgical treatment for open-angle glaucoma. Expert Rev Ophthalmol 2009;4:119-128.
  16. Mizoguchi T, Nishigaki S, Sato T, et al. Clinical results of Trabectome surgery for open-angle glaucoma. Clin Ophthalmol. 2015 Oct 9;9:1889-1894.
  17. Ahuja Y, Ma Khin Pyi S, Malihi M, Hodge DO, Sit AJ. Clinical results of ab interno trabeculotomy using the trabectome for open-angle glaucoma: the Mayo Clinic series in Rochester, Minnesota. Am J Ophthalmol. 2013 Nov;156(5): 927-935.e2.
  18. Hashemian SJ, Miraftabi A, Jafari ME, et al. Combined cataract extraction and trabeculotomy by the internal approach for coexisting cataract and open-angle glaucoma. J Curr Ophthalmol. 2016 Oct 4;29(1):17-22.
  19. Lee JW, Yick DW, Tsang S, et al. Efficacy and Safety of Trabectome Surgery in Chinese Open-Angle Glaucoma. Medicine (Baltimore). 2016 Apr;95(15): e3212.
  20. Shoji N, Kasahara M, Iijima A, et al. Short-term evaluation of Trabectome surgery performed on Japanese patients with open-angle glaucoma. Jpn J Ophthalmol. 2016 May;60(3):156-165.
  21. Loewen RT, Roy P, Parikh HA, et al. Impact of a Glaucoma Severity Index on Results of Trabectome Surgery: Larger Pressure Reduction in More Severe Glaucoma. PLoS One. 2016 Mar 23;11(3): e0151926.
  22. Yildirim Y, Kar T, Duzgun E, et al. Evaluation of the longterm results of trabectome surgery. Int Ophthalmol. 2016 Oct;36(5):719-726.
  23. Werth JP, Gesser C, Klemm M. Diverse effectiveness of the trabectome for different types of glaucoma. Klin Monbl Augenheilkd. 2015 Jan;232(1):72-78.
  24. Ting JL, Damji KF, Stiles MC. Trabectome Study Group. Ab interno trabeculectomy: outcomes in exfoliation versus primary open-angle glaucoma. J Cataract Refract Surg. 2012 Feb;38(2):315-323.
  25. Roy P, Loewen RT, Dang Y, et al. Stratification of phacotrabectome surgery results using a glaucoma severity index in a retrospective analysis. BMC Ophthalmol. 2017 Mar 21;17(1):30.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.