The Tube Versus Trabeculectomy Study: interpretation of results and application to clinical practice.

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 C (MMC) in eyes with previous cataract and/or failed glaucoma surgery. This article interprets results from the TVT Study and applies them to clinical practice. RECENT FINDINGS: Both tube-shunt surgery and trabeculectomy with MMC produced intraocular pressure (IOP) reduction to the low teens throughout the 5-year duration of the study. Tube-shunt surgery was associated with use of more glaucoma medications than trabeculectomy with MMC during the first 2 years of the study, but medical therapy equalized with longer follow-up. Trabeculectomy with MMC had higher rates of surgical failure and reoperation for glaucoma compared with tube-shunt surgery. Vision loss occurred at a similar rate with the two surgical procedures. Early complications were more frequent after trabeculectomy with MMC relative to tube-shunt surgery, but both procedures had similar rates of late postoperative complications and serious complications. SUMMARY: Tube-shunt surgery and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients who have undergone prior cataract and/or failed filtering surgery. Results of the TVT Study support the expanding use of tube shunts beyond refractory glaucomas.

Full Text

Duke Authors

Cited Authors

  • Gedde, SJ; Singh, K; Schiffman, JC; Feuer, WJ; Tube Versus Trabeculectomy Study Group,

Published Date

  • March 2012

Published In

Volume / Issue

  • 23 / 2

Start / End Page

  • 118 - 126

PubMed ID

  • 22249235

Electronic International Standard Serial Number (EISSN)

  • 1531-7021

Digital Object Identifier (DOI)

  • 10.1097/ICU.0b013e32834ff2d1

Language

  • eng

Conference Location

  • United States