Outcomes of Second Trabeculectomy Versus Glaucoma Drainage Device in Juvenile Open-angle Glaucoma After Primary Trabeculectomy Failure.

IF 2 4区 医学 Q2 OPHTHALMOLOGY
Kasem Seresirikachorn, Kornkamol Annopawong, Nucharee Parivisutt, Boonsong Wanichwecharungruang, David S Friedman, Daniel M Vu
{"title":"Outcomes of Second Trabeculectomy Versus Glaucoma Drainage Device in Juvenile Open-angle Glaucoma After Primary Trabeculectomy Failure.","authors":"Kasem Seresirikachorn, Kornkamol Annopawong, Nucharee Parivisutt, Boonsong Wanichwecharungruang, David S Friedman, Daniel M Vu","doi":"10.1097/IJG.0000000000002525","DOIUrl":null,"url":null,"abstract":"<p><strong>Precis: </strong>Second trabeculectomy and glaucoma drainage device implantation offer similar success rates for juvenile open angle glaucoma after initial trabeculectomy failure. However, second trabeculectomies required fewer medications. A quarter of patients in both groups required a third operation after 2.5±2.3 years.</p><p><strong>Purpose: </strong>To compare outcomes between second trabeculectomy surgery versus glaucoma drainage device (GDD) insertion in juvenile open-angle glaucoma (JOAG) patients after primary trabeculectomy failure.</p><p><strong>Method: </strong>A retrospective review was performed on all JOAG patients who underwent a second glaucoma surgery after primary trabeculectomy failure across two tertiary hospitals in Bangkok, Thailand between 2009 and 2020. Demographics, intraoperative reports, and clinical findings were collected. The primary outcomes were complete and qualified success rates at 5 years; secondary outcomes included differences in intraocular pressures and number of glaucoma medications post-operatively.</p><p><strong>Results: </strong>Fifty-two eyes of 38 patients underwent a second glaucoma surgery after primary trabeculectomy: 30 had a second trabeculectomy, 17 received a GDD (10 valved, 7 non-valved), and 5 underwent cyclophotocoagulation. Prior to surgery, there were no significant differences except in mean refractive error. Average follow-up length was 66.9±53.7 months. Qualified success rates were 81.5% and 63.2% at 3 and 5 years (complete success: 55.6% and 42.1%) for the second trabeculectomy group and 80.0% and 70.0% (complete success: 53.3% and 50.0%) for the GDD group, respectively. There were no significant differences in group success or IOP post-operatively. The GDD group required more medications at 5 years (1.3±1.9 vs. 2.3±1.5, P=0.03). Two cases of tube exposure in the GDD group resulted in implant removal. About a quarter of patients in both groups required a third operation after 2.5±2.3 years.</p><p><strong>Conclusion: </strong>Both second trabeculectomy and GDD insertion are effective treatments for JOAG after trabeculectomy failure. Second trabeculectomy required fewer medications for IOP control.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Glaucoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IJG.0000000000002525","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Precis: Second trabeculectomy and glaucoma drainage device implantation offer similar success rates for juvenile open angle glaucoma after initial trabeculectomy failure. However, second trabeculectomies required fewer medications. A quarter of patients in both groups required a third operation after 2.5±2.3 years.

Purpose: To compare outcomes between second trabeculectomy surgery versus glaucoma drainage device (GDD) insertion in juvenile open-angle glaucoma (JOAG) patients after primary trabeculectomy failure.

Method: A retrospective review was performed on all JOAG patients who underwent a second glaucoma surgery after primary trabeculectomy failure across two tertiary hospitals in Bangkok, Thailand between 2009 and 2020. Demographics, intraoperative reports, and clinical findings were collected. The primary outcomes were complete and qualified success rates at 5 years; secondary outcomes included differences in intraocular pressures and number of glaucoma medications post-operatively.

Results: Fifty-two eyes of 38 patients underwent a second glaucoma surgery after primary trabeculectomy: 30 had a second trabeculectomy, 17 received a GDD (10 valved, 7 non-valved), and 5 underwent cyclophotocoagulation. Prior to surgery, there were no significant differences except in mean refractive error. Average follow-up length was 66.9±53.7 months. Qualified success rates were 81.5% and 63.2% at 3 and 5 years (complete success: 55.6% and 42.1%) for the second trabeculectomy group and 80.0% and 70.0% (complete success: 53.3% and 50.0%) for the GDD group, respectively. There were no significant differences in group success or IOP post-operatively. The GDD group required more medications at 5 years (1.3±1.9 vs. 2.3±1.5, P=0.03). Two cases of tube exposure in the GDD group resulted in implant removal. About a quarter of patients in both groups required a third operation after 2.5±2.3 years.

Conclusion: Both second trabeculectomy and GDD insertion are effective treatments for JOAG after trabeculectomy failure. Second trabeculectomy required fewer medications for IOP control.

求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Glaucoma
Journal of Glaucoma 医学-眼科学
CiteScore
4.20
自引率
10.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信