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Three-year follow-up of the tube versus trabeculectomy study.

Publication ,  Journal Article
Gedde, SJ; Schiffman, JC; Feuer, WJ; Herndon, LW; Brandt, JD; Budenz, DL; Tube Versus Trabeculectomy Study Group,
Published in: Am J Ophthalmol
November 2009

PURPOSE: To report 3-year results of the Tube Versus Trabeculectomy (TVT) Study. DESIGN: Multicenter randomized clinical trial. SETTING: Seventeen clinical centers. STUDY POPULATION: Patients 18 to 85 years of age who had previous trabeculectomy, cataract extraction with intraocular lens implantation, or both and uncontrolled glaucoma with intraocular pressure (IOP) > or =18 mm Hg and < or =40 mm Hg on maximum tolerated medical therapy. INTERVENTIONS: A 350-mm(2) Baerveldt glaucoma implant or trabeculectomy with mitomycin C (MMC 0.4 mg/ml for 4 minutes). MAIN OUTCOME MEASURES: IOP, visual acuity, use of supplemental medical therapy, surgical complications, and failure (IOP >21 mm Hg or not reduced by 20%, IOP < or =5 mm Hg, reoperation for glaucoma, or loss of light perception vision). RESULTS: A total of 212 eyes of 212 patients were enrolled, including 107 in the tube group and 105 in the trabeculectomy group. At 3 years, IOP (mean +/- standard deviation [SD]) was 13.0 +/- 4.9 mm Hg in the tube group and 13.3 +/- 6.8 mm Hg in the trabeculectomy group (P = .78). The number of glaucoma medications (mean +/- SD) was 1.3 +/- 1.3 in the tube group and 1.0 +/- 1.5 in the trabeculectomy group (P = .30). The cumulative probability of failure during the first 3 years of follow-up was 15.1% in the tube group and 30.7% in the trabeculectomy group (P = .010; hazards ratio, 2.2; 95% confidence interval, 1.2 to 4.1). Postoperative complications developed in 42 patients (39%) in the tube group and 63 patients (60%) in the trabeculectomy group (P = .004). Surgical complications were associated with reoperation and/or loss of > or =2 Snellen lines in 24 patients (22%) in the tube group and 28 patients (27%) in the trabeculectomy group (P = .58). CONCLUSIONS: Tube shunt surgery had a higher success rate compared to trabeculectomy with MMC during the first 3 years of follow-up in the TVT Study. Both procedures were associated with similar IOP reduction and use of supplemental medical therapy at 3 years. While the incidence of postoperative complications was higher following trabeculectomy with MMC relative to tube shunt surgery, most complications were transient and self-limited.

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Published In

Am J Ophthalmol

DOI

EISSN

1879-1891

Publication Date

November 2009

Volume

148

Issue

5

Start / End Page

670 / 684

Location

United States

Related Subject Headings

  • Young Adult
  • Visual Acuity
  • Treatment Outcome
  • Trabeculectomy
  • Tonometry, Ocular
  • Reoperation
  • Prosthesis Implantation
  • Prospective Studies
  • Postoperative Complications
  • Ophthalmology & Optometry
 

Citation

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MLA
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Gedde, S. J., Schiffman, J. C., Feuer, W. J., Herndon, L. W., Brandt, J. D., Budenz, D. L., & Tube Versus Trabeculectomy Study Group, . (2009). Three-year follow-up of the tube versus trabeculectomy study. Am J Ophthalmol, 148(5), 670–684. https://doi.org/10.1016/j.ajo.2009.06.018
Gedde, Steven J., Joyce C. Schiffman, William J. Feuer, Leon W. Herndon, James D. Brandt, Donald L. Budenz, and Donald L. Tube Versus Trabeculectomy Study Group. “Three-year follow-up of the tube versus trabeculectomy study.Am J Ophthalmol 148, no. 5 (November 2009): 670–84. https://doi.org/10.1016/j.ajo.2009.06.018.
Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL, et al. Three-year follow-up of the tube versus trabeculectomy study. Am J Ophthalmol. 2009 Nov;148(5):670–84.
Gedde, Steven J., et al. “Three-year follow-up of the tube versus trabeculectomy study.Am J Ophthalmol, vol. 148, no. 5, Nov. 2009, pp. 670–84. Pubmed, doi:10.1016/j.ajo.2009.06.018.
Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL, Tube Versus Trabeculectomy Study Group. Three-year follow-up of the tube versus trabeculectomy study. Am J Ophthalmol. 2009 Nov;148(5):670–684.
Journal cover image

Published In

Am J Ophthalmol

DOI

EISSN

1879-1891

Publication Date

November 2009

Volume

148

Issue

5

Start / End Page

670 / 684

Location

United States

Related Subject Headings

  • Young Adult
  • Visual Acuity
  • Treatment Outcome
  • Trabeculectomy
  • Tonometry, Ocular
  • Reoperation
  • Prosthesis Implantation
  • Prospective Studies
  • Postoperative Complications
  • Ophthalmology & Optometry