Outcome of primary trabeculotomy ab interno (Trabectome) surgery in patients with steroid-induced glaucoma.
Medicine (Baltimore)
; 95(50): e5383, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-27977576
ABSTRACT
To determine the efficacy and safety of Trabectome surgery on patients with steroid response, ranging from ocular hypertension refractory to maximal medical therapy to the development of steroid-induced glaucoma.A nonrandomized, nonblinded, retrospective study of 20 subjects with steroid response was conducted. All 20 eyes underwent Trabectome surgery alone. Nine subjects had steroid response with unremarkable visual field, 3 had mild steroid-induced glaucoma, and 8 had advanced steroid-induced glaucoma. Outcome measures included intraocular pressure (IOP), number of glaucoma medications, need for secondary glaucoma surgery, and steroid regimen. Mann-Whitney U test was used to compare postoperative IOP and number of medications to preoperative IOP and number of medications. Kaplan-Meier was used for survival analysis, and success was defined as IOP reduced by 20% or more on any 2 consecutive visits after 3 months; IOP ≤21âmm Hg on any 2 consecutive visits after 3 months; and no secondary glaucoma surgery.The average preoperative IOP was 33.8â±â6.9âmm Hg and average preoperative glaucoma medication usage was 3.85â±â0.75 medications. At 12 months, the IOP was reduced to 15.00â±â3.46âmm Hg (Pâ=â0.03) and glaucoma medication was reduced to 2.3â±â1.4 (Pâ<â0.01). The survival rate at 12 months was 93%. At 12 months, 10 patients were continued on their preoperative steroid treatments, 5 were on tapered steroid treatments, and 5 had ceased steroid treatments entirely. One patient required secondary glaucoma surgery (glaucoma drainage device). No other complications were noted.The Trabectome procedure is safe and highly effective for steroid-response glaucoma, even in the context of continued steroid treatment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trabeculectomia
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Glaucoma
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Corticosteroides
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Medicine (Baltimore)
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Japão