Evaluation Of Surgical Treatment of Trabectome In Japanese Patients With Primary Open-Angle Glaucoma

1. Masahiro Maeda¹
2. Mitsunori Watanabe²
3. Kazuo Ichikawa²
4. Shuya Hara²
5. Hideki Nakamura²
6. Kei Ichikawa²

¹Gifu Red Cross Hospital, Gifu, Japan
²Social Insurance Chukyo Hospital, Nagoya, Japan

Purpose: To evaluate the surgical treatment of Trabectome with or without cataract surgery in adult Japanese patients with primary open-angle glaucoma (POAG).

Methods: Surgical device, Trabectome, was evaluated in retrospective case series involving 43 eyes of 34 adult Japanese patients with POAG (ages range 30-86, 18 males & 25 females) with or without previous surgery or laser treatment. 11 cases were performed with only Trabectome and 32 cases were performed with combined cataract extraction and Trabectome by single surgeon. Goldmann applanation intraocular pressure (IOP), adjunctive medications, corneal endothelial cell density, and best corrected visual acuity were measured before and after surgery. Intraoperative and postoperative adverse events were also tabulated.

Results: Mean pre-operative IOP of Trabectome only and Trabectome with phaco decreased from 28.0±6.5 mm Hg and 21.3±5.3 to 18.7±2.4 mm Hg and 15.3±3.5 respectively by 6 months after surgery [N=6 and 25]. The number of adjunctive medications of Trabectome only and Trabectome with phaco decreased from 3.3 ± 0.8 and 2.7±1.4 to 2.5±0.8 and 1.6±1.1 respectively at 12 months after surgery [N=6 and 25]. Intraoperative blood reflux occurred in 100% of cases. No vision-threatening complications such as choroidal effusion, choroidal hemorrhage, or infection occurred. 3 cases received surgical re-intervention. No significant change of endothelial cell density was recognized.

Conclusion: Trabectome surgical treatment is an effective and safe alternative method of lowering IOP in POAG today.