Motility disturbances in the tube versus trabeculectomy study during the first year of follow-up.
OBJECTIVE
To describe the preoperative and postoperative motility disturbances encountered in the Tube Versus Trabeculectomy (TVT) Study during the first year of follow-up.


METHODS
Multicenter randomized clinical trial.


METHODS
settings: Seventeen clinical centers. population: Patients 18 to 85 years old who had previous trabeculectomy and/or cataract surgery and uncontrolled glaucoma with intraocular pressure > or =18 mm Hg and < or =40 mm Hg on maximum tolerated medical therapy. interventions: 350-mm(2) Baerveldt glaucoma implant or trabeculectomy with mitomycin C (MMC). main outcome measures: Preoperative and postoperative evaluation of ocular motility and diplopia.


RESULTS
Motility disturbances were detected in 55 patients (28%) at baseline. New-onset persistent diplopia was reported in 5 patients (5%) in the tube group and no patients in the trabeculectomy group at 1 year (P = .06). A new postoperative motility disturbance developed or worsened in 7 patients (9.9%) in the tube group and no patients in the trabeculectomy group during the first year of follow-up (P = .005). Postoperative motility disturbances were also associated with increasing age (P < .001) and right eye surgery (P = .044).


CONCLUSIONS
Preoperative motility disturbances were common among patients in the TVT Study. New postoperative motility disturbances were more frequent following tube shunt surgery than trabeculectomy with MMC after 1 year of follow-up.
Rauscher
Frederick M
FM
Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33136, USA.
Gedde
Steven J
SJ
Schiffman
Joyce C
JC
Feuer
William J
WJ
Barton
Keith
K
Lee
Richard K
RK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000627:therapeutic use; D004172:Diplopia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D015835:Ocular Motility Disorders / Q000209:etiology*; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D014130:Trabeculectomy; D055815:Young Adult
D000477:Alkylating Agents; D016685:Mitomycin