Postoperative complications in the tube versus trabeculectomy (TVT) study during five years of follow-up

Steven J. Gedde, Leon W. Herndon, James D Brandt, Donald L. Budenz, William J. Feuer, Joyce C. Schiffman

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Abstract

Purpose: To describe postoperative complications encountered in the Tube Versus Trabeculectomy (TVT) Study during 5 years of follow-up. Design: Multicenter randomized clinical trial. Methods: settings: Seventeen clinical centers. study population: Patients 18 to 85 years of age who had previous trabeculectomy and/or cataract extraction with intraocular lens implantation and uncontrolled glaucoma with intraocular pressure (IOP) <18 mm Hg and ≤40 mm Hg on maximum tolerated medical therapy. interventions: Tube shunt (350-mm 2 Baerveldt glaucoma implant) or trabeculectomy with mitomycin C (MMC 0.4 mg/mL for 4 minutes). main outcome measures: Surgical complications, reoperations for complications, visual acuity, and cataract progression. Results: Early postoperative complications occurred in 22 patients (21%) in the tube group and 39 patients (37%) in the trabeculectomy group (P =.012). Late postoperative complications developed in 36 patients (34%) in the tube group and 38 patients (36%) in the trabeculectomy group during 5 years of follow-up (P =.81). The rate of reoperation for complications was 22% in the tube group and 18% in the trabeculectomy group (P =.29). Cataract extraction was performed in 13 phakic eyes (54%) in the tube group and 9 phakic eyes (43%) in the trabeculectomy group (P =.43). Conclusions: A large number of surgical complications were observed in the TVT Study, but most were transient and self-limited. The incidence of early postoperative complications was higher following trabeculectomy with MMC than tube shunt surgery. The rates of late postoperative complications, reoperation for complications, and cataract extraction were similar with both surgical procedures after 5 years of follow-up.

Original languageEnglish (US)
JournalAmerican Journal of Ophthalmology
Volume153
Issue number5
DOIs
StatePublished - May 2012

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Trabeculectomy
Cataract Extraction
Reoperation
Glaucoma
Glaucoma Drainage Implants
Intraocular Lens Implantation
Mitomycin
Intraocular Pressure
Cataract
Visual Acuity
Randomized Controlled Trials
Outcome Assessment (Health Care)
Incidence

ASJC Scopus subject areas

  • Ophthalmology

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Postoperative complications in the tube versus trabeculectomy (TVT) study during five years of follow-up. / Gedde, Steven J.; Herndon, Leon W.; Brandt, James D; Budenz, Donald L.; Feuer, William J.; Schiffman, Joyce C.

In: American Journal of Ophthalmology, Vol. 153, No. 5, 05.2012.

Research output: Contribution to journalArticle

Gedde, Steven J. ; Herndon, Leon W. ; Brandt, James D ; Budenz, Donald L. ; Feuer, William J. ; Schiffman, Joyce C. / Postoperative complications in the tube versus trabeculectomy (TVT) study during five years of follow-up. In: American Journal of Ophthalmology. 2012 ; Vol. 153, No. 5.
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abstract = "Purpose: To describe postoperative complications encountered in the Tube Versus Trabeculectomy (TVT) Study during 5 years of follow-up. Design: Multicenter randomized clinical trial. Methods: settings: Seventeen clinical centers. study population: Patients 18 to 85 years of age who had previous trabeculectomy and/or cataract extraction with intraocular lens implantation and uncontrolled glaucoma with intraocular pressure (IOP) <18 mm Hg and ≤40 mm Hg on maximum tolerated medical therapy. interventions: Tube shunt (350-mm 2 Baerveldt glaucoma implant) or trabeculectomy with mitomycin C (MMC 0.4 mg/mL for 4 minutes). main outcome measures: Surgical complications, reoperations for complications, visual acuity, and cataract progression. Results: Early postoperative complications occurred in 22 patients (21{\%}) in the tube group and 39 patients (37{\%}) in the trabeculectomy group (P =.012). Late postoperative complications developed in 36 patients (34{\%}) in the tube group and 38 patients (36{\%}) in the trabeculectomy group during 5 years of follow-up (P =.81). The rate of reoperation for complications was 22{\%} in the tube group and 18{\%} in the trabeculectomy group (P =.29). Cataract extraction was performed in 13 phakic eyes (54{\%}) in the tube group and 9 phakic eyes (43{\%}) in the trabeculectomy group (P =.43). Conclusions: A large number of surgical complications were observed in the TVT Study, but most were transient and self-limited. The incidence of early postoperative complications was higher following trabeculectomy with MMC than tube shunt surgery. The rates of late postoperative complications, reoperation for complications, and cataract extraction were similar with both surgical procedures after 5 years of follow-up.",
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N2 - Purpose: To describe postoperative complications encountered in the Tube Versus Trabeculectomy (TVT) Study during 5 years of follow-up. Design: Multicenter randomized clinical trial. Methods: settings: Seventeen clinical centers. study population: Patients 18 to 85 years of age who had previous trabeculectomy and/or cataract extraction with intraocular lens implantation and uncontrolled glaucoma with intraocular pressure (IOP) <18 mm Hg and ≤40 mm Hg on maximum tolerated medical therapy. interventions: Tube shunt (350-mm 2 Baerveldt glaucoma implant) or trabeculectomy with mitomycin C (MMC 0.4 mg/mL for 4 minutes). main outcome measures: Surgical complications, reoperations for complications, visual acuity, and cataract progression. Results: Early postoperative complications occurred in 22 patients (21%) in the tube group and 39 patients (37%) in the trabeculectomy group (P =.012). Late postoperative complications developed in 36 patients (34%) in the tube group and 38 patients (36%) in the trabeculectomy group during 5 years of follow-up (P =.81). The rate of reoperation for complications was 22% in the tube group and 18% in the trabeculectomy group (P =.29). Cataract extraction was performed in 13 phakic eyes (54%) in the tube group and 9 phakic eyes (43%) in the trabeculectomy group (P =.43). Conclusions: A large number of surgical complications were observed in the TVT Study, but most were transient and self-limited. The incidence of early postoperative complications was higher following trabeculectomy with MMC than tube shunt surgery. The rates of late postoperative complications, reoperation for complications, and cataract extraction were similar with both surgical procedures after 5 years of follow-up.

AB - Purpose: To describe postoperative complications encountered in the Tube Versus Trabeculectomy (TVT) Study during 5 years of follow-up. Design: Multicenter randomized clinical trial. Methods: settings: Seventeen clinical centers. study population: Patients 18 to 85 years of age who had previous trabeculectomy and/or cataract extraction with intraocular lens implantation and uncontrolled glaucoma with intraocular pressure (IOP) <18 mm Hg and ≤40 mm Hg on maximum tolerated medical therapy. interventions: Tube shunt (350-mm 2 Baerveldt glaucoma implant) or trabeculectomy with mitomycin C (MMC 0.4 mg/mL for 4 minutes). main outcome measures: Surgical complications, reoperations for complications, visual acuity, and cataract progression. Results: Early postoperative complications occurred in 22 patients (21%) in the tube group and 39 patients (37%) in the trabeculectomy group (P =.012). Late postoperative complications developed in 36 patients (34%) in the tube group and 38 patients (36%) in the trabeculectomy group during 5 years of follow-up (P =.81). The rate of reoperation for complications was 22% in the tube group and 18% in the trabeculectomy group (P =.29). Cataract extraction was performed in 13 phakic eyes (54%) in the tube group and 9 phakic eyes (43%) in the trabeculectomy group (P =.43). Conclusions: A large number of surgical complications were observed in the TVT Study, but most were transient and self-limited. The incidence of early postoperative complications was higher following trabeculectomy with MMC than tube shunt surgery. The rates of late postoperative complications, reoperation for complications, and cataract extraction were similar with both surgical procedures after 5 years of follow-up.

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