Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity [version 2; referees: 3 approved]
Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual fi...
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2016-06-01
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| Series: | F1000Research |
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| Online Access: | http://f1000research.com/articles/5-762/v2 |
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| author | Yalong Dang Pritha Roy Igor I. Bussel Ralitsa T. Loewen Hardik Parikh Nils A. Loewen |
| author_facet | Yalong Dang Pritha Roy Igor I. Bussel Ralitsa T. Loewen Hardik Parikh Nils A. Loewen |
| author_sort | Yalong Dang |
| collection | DOAJ |
| description | Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. In the analysis presented here, we combined data of trabectome alone and trabectome with same session cataract surgery to increase testing power and chances of effect discovery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities. |
| first_indexed | 2024-04-13T10:25:06Z |
| format | Article |
| id | doaj.art-695b76cb360d4b55be5aab7763070c0c |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-04-13T10:25:06Z |
| publishDate | 2016-06-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-695b76cb360d4b55be5aab7763070c0c2022-12-22T02:50:21ZengF1000 Research LtdF1000Research2046-14022016-06-01510.12688/f1000research.8448.29711Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity [version 2; referees: 3 approved]Yalong Dang0Pritha Roy1Igor I. Bussel2Ralitsa T. Loewen3Hardik Parikh4Nils A. Loewen5Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, USADepartment of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, USADepartment of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, USADepartment of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, USADepartment of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, USADepartment of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, USAPrior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. In the analysis presented here, we combined data of trabectome alone and trabectome with same session cataract surgery to increase testing power and chances of effect discovery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities.http://f1000research.com/articles/5-762/v2Glaucoma |
| spellingShingle | Yalong Dang Pritha Roy Igor I. Bussel Ralitsa T. Loewen Hardik Parikh Nils A. Loewen Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity [version 2; referees: 3 approved] F1000Research Glaucoma |
| title | Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity [version 2; referees: 3 approved] |
| title_full | Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity [version 2; referees: 3 approved] |
| title_fullStr | Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity [version 2; referees: 3 approved] |
| title_full_unstemmed | Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity [version 2; referees: 3 approved] |
| title_short | Combined analysis of trabectome and phaco-trabectome outcomes by glaucoma severity [version 2; referees: 3 approved] |
| title_sort | combined analysis of trabectome and phaco trabectome outcomes by glaucoma severity version 2 referees 3 approved |
| topic | Glaucoma |
| url | http://f1000research.com/articles/5-762/v2 |
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