Seguridad y eficacia de la trabeculectomía de irrigación (Trabectome®) en una cohorte latinoamericana con glaucoma moderado y avanzado

Abstract

Introduction and objectives

To describe the mid-term safety and efficacy profile of Trabectome® in a Latin American cohort with moderate and advanced glaucoma.

Methods and materials

We conducted a retrospective consecutive case series of 42 eyes of 39 patients treated with Trabectome® ab interno irrigating trabeculectomy. A total of 29% were treated as combined procedures with cataract surgery. A total of 71% were categorized as moderate/advanced glaucoma. Success criteria A was defined as an intraocular pressure (IOP) reduction > 20%, 5 < IOP < 21 mmHg, no reoperation, no severe complications. More restrictive definitions of success were also applied for further analysis: B (5 mmHg < IOP ≤ 18 mmHg, no reoperation, IOP reduction >20%, no severe complications); C (5 mmHg < IOP ≤ 15 mm Hg, no reoperation, IOP reduction ≥ 40%, no severe complications).

Results

Mean IOP dropped from 22.2 ± 8.0 down to 15.2 ± 3.7 mmHg (20.5 ± 12.7-months follow up, 30% reduction) (P<.0001). Success rates in the overall group were 71% (A), 62% (B), and 19% (C). Complications included intraoperative arterial hemorrhages in 2 cases (4.8%) and late blood reflux in another 2 (4.8%). Six eyes (14%) required reoperation due to treatment failure. A total of 21 eyes (50%) had baseline IOP levels ≥ 22 mmHg. In this subgroup, IOP dropped from 28.3 ± 5.5 down to 16.6 ± 3.0 (40% reduction) (P<.0001) and success rates were 81% (A), 62% (B) and 29% (C).

Conclusions

Trabectome® is an effective and safe technique to lower IOP in this Latin American cohort representing the whole spectrum of disease severity and miscellaneous clinical scenarios.