Original articleAb Interno Trabeculectomy Versus Trabeculectomy for Open-Angle Glaucoma
Section snippets
Materials and Methods
All study procedures were approved by the institutional review board of the Massachusetts Eye and Ear Infirmary and the University of Southern California in adherence with the Declaration of Helsinki and the Health Insurance Portability and Accountability Act. We retrospectively reviewed the medical records of all patients who underwent primary ab interno trabeculectomy, subsequently named the “study group” between February 2006 and September 2009, and trabeculectomy, subsequently named the
Results
A total of 417 patients (417 eyes) met the inclusion criteria. Two hundred patients were excluded for the occurrence of concurrent surgery. Of the 200 eyes that were excluded, 124 were from the study group and 76 were from the trabeculectomy group; 191 had concurrent cataract surgery. A total of 217 patients (217 eyes) were included in this study; 115 cases had ab interno trabeculectomy (study group), and 102 cases had trabeculectomy as an initial surgical procedure for medically uncontrolled
Baseline Characteristics
The baseline demographic and medical characteristics of the patients in each group were equivalent except baseline VA, previous laser trabeculoplasty, and cup-to-disc ratio (Table 1, available at http://aaojournal.org). Baseline VA was better in the study group (0.34±0.40 vs. 0.63±0.82; P=0.001). There were more patients who had previous argon or selective laser trabeculoplasty in the study group (47.8% vs. 30.4%; P = 0.031), and cup-to-disc ratio was larger in the trabeculectomy group
Discussion
Our data demonstrate that both ab interno trabeculectomy and trabeculectomy lower IOP. Trabeculectomy had a greater success rate with lower mean IOP and less need for supplemental antiglaucoma medications at all time points. The results of our trabeculectomy arm were approximately comparable to the literature. In our series, trabeculectomy had success rates of 85.6% and 76.1% at 1 and 2 years, respectively, using modified TVT criteria. The trabeculectomy arm of the TVT study reported success
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Manuscript no. 2010-1387.
Financial Disclosure(s): The author(s) have made the following disclosure(s): Dr. Francis is a consultant for NeoMedix, Inc. The other authors have no proprietary or commercial interest in any materials discussed in this article.
This article contains online-only material. The following should appear online-only: Tables 1, 2, and 7.