Trabectome Outcomes: No Prior Laser Trabeculoplasty Versus With Prior Laser Trabeculoplasty

Saturday, April 18, 2015: 4:16 PM
Room 1B (San Diego Convention Center)
Quang H. Nguyen, MD

To evaluate the effect of previous trabeculoplasty on trabectome outcomes.

All cases had at least 12 months of follow-up.  Cases were excluded if they had any other prior glaucoma surgery other than laser trabeculoplasty (LTP) or if they received any other concurrent surgery with Trabectome except phacoemulsification.   A total of 1038 cases with no prior LTP (NLTP) and 505 cases with prior LTP were included in this study.  Major outcomes include IOP, number of glaucoma medications and secondary glaucoma surgery, if any.  Kaplan-Meier was used for survival analysis and success was defined as IOP ≤ 21mmHg, at least 20% IOP reduction from baseline for any two consecutive visits after 3 months and no secondary glaucoma surgery.

Average IOP was reduced from 23.8±8.1 mmHg to 16.1±4.0 mmHg at 12 months (p<0.01) in NLTP group and 23.0±7.5 mmHg to 16.5±4.1 mmHg in LTP group (p<0.01*).   Both groups showed statistically significant differences in IOP when compared to baseline.  However, no statistically significant difference was found between groups at 12 months.  In NLTP cases, average number of glaucoma medications was reduced from 2.6±1.3 to 1.8±1.3 (p<0.01*) and 2.7±1.3 to 2.1±1.3 (p<0.01*) in LTP cases.  Statistically significant difference was found between groups at 12 months.  The survival rate at 12 month was 85% and 80% in NLTP and LTP group, respectively.  Log-rank test suggests the two survival curves are statistically significantly different (p<0.01*).

Prior LTP surgery does not appear to affect IOP reduction after Trabectome surgery.  However, cases with prior LTP showed less reduction in number of glaucoma medications.