TUBE VERSUS TRABECULECTOMY IN JUVENILE-ONSET OPEN ANGLE GLAUCOMA – TREATMENT OUTCOMES IN TERTIARY HOSPITALS IN MALAYSIA

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Autoři: MR. Hadi Abd ^1,2,3; WJ. Ang ¹; RO. Norliza Raja ¹; H. Norhalwani ⁴; Y. Azhany ^2,3; AT. Liza-Sharmini ^2,3
Působiště autorů: Department of Ophthalmology, Hospital Melaka, Melaka ¹; Department of Ophthalmology and Visual Sciences, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan ²; Eye Clinic, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan ³; Department of Ophthalmology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan ⁴
Vyšlo v časopise: Čes. a slov. Oftal., 78, 2022, No. 6, p. 298-303
Kategorie: Původní práce
doi: https://doi.org/10.31348/2022/29

Souhrn

Aim of the study: To compare the intraocular pressure (IOP) lowering effect and postoperative complications between primary augmented trabeculectomy and glaucoma drainage device (GDD) implantation as primary surgical intervention in patients with juvenile-onset open angle glaucoma (JOAG).

Patients and Methods: A retrospective review study involving 20 eyes that underwent primary augmented trabeculectomy with mitomycin (MMC) and 10 eyes GDD implantation in 3 tertiary centres in Malaysia between 1 January 2013 and 31 December 2019. They were followed up for at least 12 months postsurgical intervention. Intraocular pressure (IOP), number of topical IOP lowering medication and complications were evaluated at 1, 3, 6 and 12 months post-intervention. Based on the IOP, the success was divided into complete and partial success, and failure. IOP and postsurgical complications were compared using the Repetitive Measure Analysis of Variance (RM ANOVA) and the Pearson chi-square test.

Results: Both methods were effective in lowering the IOP. Eyes with primary augmented trabeculectomy have significant lower IOP compared to GDD implantation (p = 0.037). There was a higher incidence of postoperative hypotony (30%) in the trabeculectomy group. There was also a significant reduction of mean number of topical pressure-lowering drugs required postoperatively (p = 0.015). Complete success was achieved in 100% of eyes with trabeculectomy and 67% in GDD implantation (p = 0.047).

Conclusions: Primary augmented trabeculectomy and GDD implantation are good surgical options for the treatment of JOAG. Both methods provide IOP lowering at 1 year. However, trabeculectomy provides better pressure lowering, compared to GDD implantation in patients with JOAG.

Zdroje

1. Pathania D, Senthil S, Rao H, Mandal AK, Garudari CS. Outcomes of trabeculectomy in juvenile open angle glaucoma. Indian J Ophthalmol. 2014;62(2):224-228.

2. Wiggs JL, Del Bono EA, Schuman JS, Hutchinson BT, Walton DS. Clinical Features of Five Pedigrees Genetically Linked to the Juvenile Glaucoma Locus on Chromosome 1q21-q31. Ophthalmology. 1995;102(12):1782-1789.

3. Ciociola, Elizabeth C., Klifto, Meredith R. Juvenile open angle glaucoma: current diagnosis and management. Curr Opin Ophthalmol. 2022 Mar 1;33(2):97-102.

4. Tsai JC, Chang HW, Kao CN, Lai IC, Teng MC. Trabeculectomy with mitomycin C versus trabeculectomy alone for juvenile primary open-angle glaucoma. Ophthalmologica. 2003;217(1):24-30.

5. Ishida K, Mandal AK, Netland PA. Glaucoma drainage implants in pediatric patients. Ophthalmol Clin North Am. 2005;18(3):431-442.

6. Djodeyre MR, Peralta Calvo J, Abelairas Gomez J. Clinical evaluation and risk factors of time to failure of Ahmed Glaucoma Valve implant in pediatric patients. Ophthalmology. 2001;108(3):614-620.

7. European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 2: Classification and terminology supported by the EGS Foundation: Part 1: Foreword; Introduction; Glossary; Chapter 2 Classification and Terminology. Br J Ophthalmol. 2017;101(5):73-127.

8. Cantor LB, Mantravadi A, WuDunn D, Swamynathan K, Cortes A. Morphologic classification of filtering blebs after glaucoma filtration surgery: The Indiana Bleb Appearance Grading Scale. J Glaucoma. 2003;12(3):266-271.

9. Islamaj E, Wubbels RJ, de Waard PWT. Primary Baerveldt versus trabeculectomy study after one-year follow-up. Acta Ophthalmol. 2018;96(6):e740-746.

10. Das JC, Chaudhuri Z, Sharma P, Bhomaj S. The Ahmed Glaucoma Valve in refractory glaucoma: Experiences in Indian eyes. Eye. 2005;19(2):183-190.

11. Le, P. H., Nguyen, M., Humphrey, K. A., & Klifto, M. R. Ahmed and Baerveldt Drainage Implants in the Treatment of Juvenile Open- -angle Glaucoma. Journal of glaucoma. 2021;30(3), 276-280.

12. Sihota R, Shakrawal J, Sidhu T et al. Does TRABECULECTOMY meet the 10-10-10 challenge in PACG, POAG, JOAG and Secondary glaucomas? Int Ophthalmol. 2020;40(5):1233-1243.

13. Riva I, Roberti G, Oddone F, Konstas AG, Quaranta L. Ahmed glaucoma valve implant: Surgical technique and complications. Clin Ophthalmol. 2017;11:357-367.

14. Kastner A, King AJ. Advanced glaucoma at diagnosis: current perspectives. Eye. 2020;34(1):116-128.

15. Broadway DC, Chang LP. Trabeculectomy, Risk Factors for Failure and the Preoperative State of the Conjunctiva. J Glaucoma 2001; 10:237-249

16. Fannin LA, Schiffman JC, Budenz DL. Risk factors for hypotony maculopathy. Ophthalmology 2003;110:1185-1191

17. Benson SE, Mandal K, Bunce CV, Fraser SG. Is post-trabeculectomy hypotony a risk factor for subsequent failure? A case control study. BMC Ophthalmology 2005; 5:7.

18. Koraszewska-Matuszewka B, Samochowiec-Donocik E, Filipek E. Prognosis in juvenile glaucoma after trabeculectomy. Klin Oczna 2002;104:115-118.

19. Stürmer J, Broadway DC, Hitchings RA. Young Patient Trabeculectomy: Assessment of Risk Factors for Failure. Ophthalmology 1993; 100: 928-939.

20. Wilson MR, Mendis U, Smith SD, Paliwai A. Ahmed glaucoma valve implant vs trabeculectomy in the surgical treatment of glaucoma: A randomized clinical trial. Am J Ophthalmol. 2000;130(3):267-273.