Treatment outcomes in the tube versus trabeculectomy study after one year of follow-up.

Abstract:

PURPOSE:To report one-year results of the Tube Versus Trabeculectomy (TVT) Study. DESIGN:Multicenter randomized clinical trial. METHODS: SETTING:17 Clinical Centers. STUDY POPULATION:Patients 18 to 85 years of age who had previous trabeculectomy and/or cataract extraction with intraocular lens implantation and uncontrolled glaucoma with intraocular pressure (IOP) > or =18 mm Hg and < or =40 mm Hg on maximum tolerated medical therapy. INTERVENTIONS:350 mm(2) Baerveldt glaucoma implant or trabeculectomy with mitomycin C (MMC). MAIN OUTCOME MEASURES:IOP, visual acuity, and reoperation for glaucoma. RESULTS:A total of 212 eyes of 212 patients were enrolled, including 107 in the tube group and 105 in the trabeculectomy group. At one year, IOP (mean +/- SD) was 12.4 +/- 3.9 mm Hg in the tube group and 12.7 +/- 5.8 mm Hg in the trabeculectomy group (P = .73). The number of glaucoma medications (mean +/- SD) was 1.3 +/- 1.3 in the tube group and 0.5 +/- 0.9 in the trabeculectomy group (P < .001). The cumulative probability of failure during the first year of follow-up was 3.9% in the tube group and 13.5% in the trabeculectomy group (P = .017). CONCLUSIONS:Nonvalved tube shunt surgery was more likely to maintain IOP control and avoid persistent hypotony or reoperation for glaucoma than trabeculectomy with MMC during the first year of follow-up in the TVT Study. Both surgical procedures produced similar IOP reduction at one year, but there was less need for supplemental medical therapy following trabeculectomy with MMC.

journal_name

Am J Ophthalmol

authors

Gedde SJ,Schiffman JC,Feuer WJ,Herndon LW,Brandt JD,Budenz DL

doi

10.1016/j.ajo.2006.07.020

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

9-22

issue

1

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(06)00860-9

journal_volume

143

pub_type

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