Trabectome (trabeculectomy-internal approach): additional experience and extended follow-up

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Management

Background:

• Open-angle glaucoma is a leading cause of irreversible blindness worldwide.
• Elevated intraocular pressure (IOP) is a primary risk factor for glaucoma progression.
• Current treatments include medication, laser therapy, and incisional surgery, each with limitations.

Purpose of the Study:

• To evaluate the safety and efficacy of the Trabectome procedure in a large cohort of glaucoma patients.
• To analyze outcomes for both Trabectome-only and combined Trabectome-phacoemulsification surgeries.
• To assess changes in intraocular pressure, medication usage, and complication rates.

Main Methods:

• Retrospective case series of 1127 patients undergoing Trabectome surgery.
• Electroablation of the trabecular meshwork via a temporal corneal incision.
• Outcomes measured included IOP, medication use, complications, and Kaplan-Meier survival analysis.

Main Results:

• Mean IOP decreased by 39% from 23.8 mmHg to 16.5 mmHg at 24 months post-surgery.
• Medication use reduced from 2.8 to 1.2 by 24 months.
• Trabectome-only cases showed a 40% IOP reduction; combined cases showed an 18% IOP reduction at 12 months. Complications were minimal, with no cases of prolonged hypotony or infection.

Conclusions:

• Trabectome surgery provides a safe and effective minimally invasive option for lowering IOP in open-angle glaucomas.
• The procedure demonstrates significant reductions in both IOP and medication requirements.
• Trabectome can be considered as a valuable tool in the glaucoma treatment algorithm.