Treatment Outcomes in the Tube Versus Trabeculectomy Study After One Year of Follow-up

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

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Abstract

Purpose: To report one-year results of the Tube Versus Trabeculectomy (TVT) Study. Design: Multicenter randomized clinical trial. Methods: setting: 17 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: 350 mm2 Baerveldt glaucoma implant or trabeculectomy with mitomycin C (MMC). main outcome measures: IOP, visual acuity, and reoperation for glaucoma. Results: A total of 212 eyes of 212 patients were enrolled, including 107 in the tube group and 105 in the trabeculectomy group. At one year, IOP (mean ± SD) was 12.4 ± 3.9 mm Hg in the tube group and 12.7 ± 5.8 mm Hg in the trabeculectomy group (P = .73). The number of glaucoma medications (mean ± SD) was 1.3 ± 1.3 in the tube group and 0.5 ± 0.9 in the trabeculectomy group (P < .001). The cumulative probability of failure during the first year of follow-up was 3.9% in the tube group and 13.5% in the trabeculectomy group (P = .017). Conclusions: Nonvalved tube shunt surgery was more likely to maintain IOP control and avoid persistent hypotony or reoperation for glaucoma than trabeculectomy with MMC during the first year of follow-up in the TVT Study. Both surgical procedures produced similar IOP reduction at one year, but there was less need for supplemental medical therapy following trabeculectomy with MMC.

Original languageEnglish (US)
JournalAmerican Journal of Ophthalmology
Volume143
Issue number1
DOIs
StatePublished - Jan 2007

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

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Treatment Outcomes in the Tube Versus Trabeculectomy Study After One Year of Follow-up. / Gedde, Steven J.; Schiffman, Joyce C.; Feuer, William J.; Herndon, Leon W.; Brandt, James D; Budenz, Donald L.

In: American Journal of Ophthalmology, Vol. 143, No. 1, 01.2007.

Research output: Contribution to journalArticle

Gedde, Steven J. ; Schiffman, Joyce C. ; Feuer, William J. ; Herndon, Leon W. ; Brandt, James D ; Budenz, Donald L. / Treatment Outcomes in the Tube Versus Trabeculectomy Study After One Year of Follow-up. In: American Journal of Ophthalmology. 2007 ; Vol. 143, No. 1.
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abstract = "Purpose: To report one-year results of the Tube Versus Trabeculectomy (TVT) Study. Design: Multicenter randomized clinical trial. Methods: setting: 17 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: 350 mm2 Baerveldt glaucoma implant or trabeculectomy with mitomycin C (MMC). main outcome measures: IOP, visual acuity, and reoperation for glaucoma. Results: A total of 212 eyes of 212 patients were enrolled, including 107 in the tube group and 105 in the trabeculectomy group. At one year, IOP (mean ± SD) was 12.4 ± 3.9 mm Hg in the tube group and 12.7 ± 5.8 mm Hg in the trabeculectomy group (P = .73). The number of glaucoma medications (mean ± SD) was 1.3 ± 1.3 in the tube group and 0.5 ± 0.9 in the trabeculectomy group (P < .001). The cumulative probability of failure during the first year of follow-up was 3.9{\%} in the tube group and 13.5{\%} in the trabeculectomy group (P = .017). Conclusions: Nonvalved tube shunt surgery was more likely to maintain IOP control and avoid persistent hypotony or reoperation for glaucoma than trabeculectomy with MMC during the first year of follow-up in the TVT Study. Both surgical procedures produced similar IOP reduction at one year, but there was less need for supplemental medical therapy following trabeculectomy with MMC.",
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