Predictability of ab-interno trabeculectomy success in the subsequent eye: A contralateral eye comparison study.
Kiessling David, Rennings Corinna, Hild Matthias, Lappas Alexandra, Dietlein Thomas S, Roessler Gernot F, Widder Randolf A
AI Summary
This study found first-eye ab-interno trabeculectomy success strongly predicts second-eye success, offering a valuable tool for patient counseling and surgical planning for bilateral glaucoma.
Abstract
Background
To determine whether the outcome of the first eye may serve as a predictor for intraocular pressure (IOP)-lowering effectiveness in the second eye following bilateral ab interno trabeculectomy.
Methods
This retrospective single-centre study included 168 eyes from 84 participants, who underwent combined Trabectome surgery with phacoemulsification cataract surgery in a hospital setting. The clinical endpoint was defined as either 'success' or 'failure' based on four separate scores at the longest follow-up time point: IOP at follow-up <21 mm Hg (Score A) or IOP < 18 mm Hg (Score B), without re-surgery and IOP reduction >20%; IOP ≤15 mm Hg without re-surgery and IOP reduction ≥40% (Score C); and the sole absence of re-surgery according to the discretion of the surgeon (Score D).
Results
No significant difference was observed between the outcomes of first and second eyes. The frequency of success in the second eye after effective surgery in the first eye significantly exceeded that after prior failure. Within our analysis, the probability calculations determined a 75% chance of success following prior success for Score A. If surgery in the first eye failed, the chance of success in the subsequent eye was 37%. The corresponding probabilities were 79% and 32% for Score B, 56% and 9% for Score C, and 99% and 50% for Score D.
Conclusion
The results of our study offer a useful tool to assess the success of subsequent eye surgeries based on the outcome in the initial eye, owing to the high predictive potential.
MeSH Terms
Shields Classification
Key Concepts6
In a retrospective single-center study including 168 eyes from 84 participants who underwent combined Trabectome surgery with phacoemulsification cataract surgery, no significant difference was observed between the outcomes of first and second eyes.
In a retrospective single-center study including 168 eyes from 84 participants who underwent combined Trabectome surgery with phacoemulsification cataract surgery, the frequency of success in the second eye after effective surgery in the first eye significantly exceeded that after prior failure.
Following combined Trabectome surgery with phacoemulsification cataract surgery, the probability of success in the subsequent eye was 75% if the first eye surgery was successful (Score A: IOP at follow-up <21 mmHg without re-surgery and IOP reduction >20%), compared to 37% if the first eye surgery failed.
Following combined Trabectome surgery with phacoemulsification cataract surgery, the probability of success in the subsequent eye was 79% if the first eye surgery was successful (Score B: IOP at follow-up <18 mmHg without re-surgery and IOP reduction >20%), compared to 32% if the first eye surgery failed.
Following combined Trabectome surgery with phacoemulsification cataract surgery, the probability of success in the subsequent eye was 56% if the first eye surgery was successful (Score C: IOP ≤15 mmHg without re-surgery and IOP reduction ≥40%), compared to 9% if the first eye surgery failed.
Following combined Trabectome surgery with phacoemulsification cataract surgery, the probability of success in the subsequent eye was 99% if the first eye surgery was successful (Score D: sole absence of re-surgery according to the discretion of the surgeon), compared to 50% if the first eye surgery failed.
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