Steroid-induced glaucoma treated with trabecular ablation in a matched comparison with primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Ocular Hypertension

Background:

• Steroid-induced glaucoma (SIG) presents unique challenges in intraocular pressure (IOP) management.
• Evaluating surgical interventions for SIG is crucial for effective treatment.

Purpose of the Study:

• To assess the efficacy of trabectome-mediated ab interno trabeculectomy in patients diagnosed with steroid-induced glaucoma (SIG).
• To compare the outcomes of trabectome surgery in SIG patients versus those with primary open-angle glaucoma (POAG).

Main Methods:

• A retrospective, observational cohort study involving 60 patients with SIG and 484 controls with POAG.
• Intraocular pressure (IOP) reduction and medication use were compared using multivariate regression and Wilcoxon tests.
• Kaplan-Meier survival analysis was employed to evaluate surgical success rates.

Main Results:

• Patients with SIG exhibited higher baseline IOP (31.4 mmHg) compared to POAG controls (24.1 mmHg).
• Trabectome surgery resulted in a significantly greater IOP reduction in SIG patients (48.4%) versus POAG patients (31.5%).
• One-year survival rates were comparable between SIG (86%) and POAG (85%) groups.

Conclusions:

• Trabectome surgery is an effective treatment for reducing IOP in patients with steroid-induced glaucoma (SIG).
• The procedure demonstrates favorable outcomes and comparable success rates to those seen in primary open-angle glaucoma (POAG) management.