Review of results from the Tube Versus Trabeculectomy Study.

Journal Article (Journal Article;Review)

PURPOSE OF REVIEW: The Tube Versus Trabeculectomy (TVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube-shunt surgery to trabeculectomy with mitomycin (MMC) in eyes with previous cataract and/or unsuccessful glaucoma surgery. This article reviews published results from the TVT Study. RECENT FINDINGS: Tube-shunt surgery had a higher success rate than trabeculectomy with MMC during the first 3 years of follow-up. Trabeculectomy with MMC produced greater intraocular pressure (IOP) reduction in the early postoperative period compared with tube-shunt placement, but similar IOPs were observed after 3 months. Tube-shunt surgery was associated with greater use of adjunctive-medical therapy than trabeculectomy with MMC during the first 2 years of the study, but no difference in medication use was seen at 3 years. The incidence of postoperative complications was higher after trabeculectomy with MMC compared with tube-shunt surgery, but serious complications associated with vision loss and/or reoperation developed with similar frequency after both surgical procedures. No difference in the rate of vision loss was present following trabeculectomy with MMC and tube-shunt surgery after 3 years of follow-up. Cataract progression was common, but occurred with similar frequency with both procedures. SUMMARY: Intermediate-term results of the TVT Study support the expanded use of tube shunts beyond refractory glaucomas. Tube-shunt surgery is an appropriate surgical option in patients who have undergone prior cataract and/or unsuccessful filtering surgery.

Full Text

Duke Authors

Cited Authors

  • Gedde, SJ; Heuer, DK; Parrish, RK; Tube Versus Trabeculectomy Study Group,

Duke Contributors

Published Date

  • March 2010

Published In

Volume / Issue

  • 21 / 2

Start / End Page

  • 123 - 128

PubMed ID

  • 20040872

Pubmed Central ID

  • PMC5584063

Electronic International Standard Serial Number (EISSN)

  • 1531-7021

Digital Object Identifier (DOI)

  • 10.1097/ICU.0b013e3283360b68

Language

  • eng

Conference Location

  • United States