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Steroid‐induced glaucoma treated with trabecular ablation in a matched comparison with primary open‐angle glaucoma
Author(s) -
Dang Yalong,
Kaplowitz Kevin,
Parikh Hardik A,
Roy Pritha,
Loewen Ralitsa T,
Francis Brian A,
Loewen Nils A
Publication year - 2016
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12796
Subject(s) - medicine , open angle glaucoma , glaucoma , ophthalmology , ablation , optometry
Background To evaluate the outcomes of trabectome‐mediated ab interno trabeculectomy in patients with steroid‐induced glaucoma (SIG). Design A retrospective, observational cohort study performed in the Department of Ophthalmology, University of Pittsburgh Medical Center. Participants The data of 60 patients with SIG and 484 controls with primary open‐angle glaucoma (POAG) matched by age, gender and glaucoma index were collected from the Trabectome Study Group database. Methods Reduction of intraocular pressure (IOP) and medications were compared between POAG and SIG by multivariate regression. Kaplan–Meier was used for survival analysis. Success was defined as IOP ≤21 mmHg and at least 20% IOP reduction from baseline for any two consecutive visits after 3 months without secondary glaucoma surgery. Postoperative IOP and number of medications were compared with baseline in the SIG subgroups by the Wilcoxon test. Main Outcome Measures Intraocular pressure reduction and 1‐year success rate. Results Patients with SIG had a higher baseline IOP (31.4 ± 10.4 vs . 24.1 ± 7.6 mmHg, P < 0.01) and obtained a greater IOP reduction than controls with POAG (48.4% vs . 31.5%, P < 0.01). Multivariate regression showed that patients with SIG had an IOP reduction of 6.7 ± 1.1 mmHg more than those with POAG. Survival rates at 12 months were comparable at 86% in the SIG group and 85% in the POAG group ( P = 0.47). Patients with SIG with a high baseline IOP, younger age and advanced glaucoma experienced a larger IOP drop. Conclusion Trabectome appears to be an effective surgical treatment in reducing IOP for patients with SIG.