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Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity.

Dang, Yalong and Roy, Pritha and Bussel, Igor I and Loewen, Ralitsa T and Parikh, Hardik and Loewen, Nils A (2016) Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity. F1000Res, 5. 762 - ?. ISSN 2046-1402

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Abstract

Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. In the analysis presented here, we combined data of trabectome alone and trabectome with same session cataract surgery to increase testing power and chances of effect discovery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Dang, Yalongyad23@pitt.eduYAD23
Roy, Pritha
Bussel, Igor I
Loewen, Ralitsa Trtl13@pitt.eduRTL13
Parikh, Hardik
Loewen, Nils ANAL58@pitt.eduNAL58
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
ReviewerMascarenhas, Kristy G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
ReviewerMyers, WilliamUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
ReviewerSarkisian Jr., Steven R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 20 June 2016
Date Type: Acceptance
Journal or Publication Title: F1000Res
Volume: 5
Page Range: 762 - ?
DOI or Unique Handle: 10.12688/f1000research.8448.2
Schools and Programs: School of Medicine > Ophthalmology
Refereed: Yes
Uncontrolled Keywords: ab interno trabeculectomy, disease index, glaucoma, outflow, surgery, trabectome
ISSN: 2046-1402
Date Deposited: 09 Aug 2016 20:03
Last Modified: 30 Oct 2018 13:58
URI: http://d-scholarship.pitt.edu/id/eprint/29110

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