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Trabectome success factors.

Constance O Okeke1, Eydie Miller-Ellis, Mario Rojas

  • 1Eastern Virginia Medical School Virginia Eye Consultants, Norfolk, VA Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia, PA.

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Trabectome surgery effectively lowers intraocular pressure and medication needs in glaucoma patients. Combination with phacoemulsification and Hispanic ethnicity are linked to better surgical outcomes.

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Outcomes

Background:

  • Trabectome surgery is a treatment option for glaucoma.
  • Understanding factors influencing its success is crucial for patient selection and management.

Purpose of the Study:

  • To identify patient characteristics and surgical factors associated with successful Trabectome surgery outcomes.
  • To analyze the impact of combined versus standalone procedures and specific glaucoma types on surgical success.

Main Methods:

  • Analysis of 658 phakic glaucoma cases with at least 12 months follow-up.
  • Collected baseline demographics and medical data.
  • Used univariate and multivariate Cox regression to determine risk factors for failure, defining success as ≥20% IOP reduction and IOP <21 mmHg without secondary surgery.

Main Results:

  • Trabectome combined with phacoemulsification (TP) showed a 94% survival rate at 12 months, compared to 79% for Trabectome alone (TA).
  • TP cases had a 78% lower risk of failure than TA. Pseudoexfoliation glaucoma and Hispanic ethnicity were associated with reduced failure risk.
  • Higher baseline intraocular pressure (IOP) correlated with greater IOP reduction post-surgery.

Conclusions:

  • Trabectome surgery, both standalone and combined with phacoemulsification, significantly reduces IOP and glaucoma medication requirements.
  • Factors enhancing Trabectome survival include pseudoexfoliation glaucoma, combination with cataract surgery, and Hispanic race.
  • Higher baseline IOP is a predictor of greater IOP reduction following Trabectome surgery.