title: Trabeculectomy ab interno with the Trabectome® as a therapeutic option for uveitic secondary glaucoma.
abstract: OBJECTIVE
  Treatment of secondary glaucoma in uveitis patients is challenging. Owing to the young age of these patients, sufficient lowering of the intraocular pressure (IOP) is essential to prevent progression of visual field loss. However, because of the chronic inflammatory stimulus, filtration surgery has an increased risk of failure, especially in patients who have previously undergone surgery. Therefore, minimally invasive glaucoma surgery is a valuable alternative.
  
  
  METHODS
  The clinical records of 24 consecutive patients with uveitic secondary glaucoma who underwent trabeculectomy ab interno with the Trabectome® at the Eye Center of the Albert-Ludwigs University of Freiburg between June 2009 and June 2014 (registered in the Freiburg trabectome database) were retrospectively analyzed. The general baseline information for each patient included age, gender, glaucoma type, ocular medication and current IOP. The postoperative IOP and number of antiglaucomatous medications were recorded at each visit. Statistical analyses were performed using the Kaplan-Meier estimator and Dunnett's t-test.
  
  
  RESULTS
  The mean IOP before surgery was 31 ± 6.7 mmHg (median 32 mmHg). Both the IOP and the number of medications significantly decreased over the various follow-up intervals after trabeculectomy ab interno with the Trabectome®. Patients with follow-ups continuing past one year showed an IOP-reduction of approximately 40 % and a medication number reduction from 2 to 0.67. The failure rate (necessitating further glaucoma surgery) was N = 3 (12.5 %) patients.
  
  
  CONCLUSIONS
  Trabeculectomy ab interno with the Trabectome® is a minimally invasive and effective method for controlling IOP in uveitic secondary glaucoma.
authors.affiliation: Eye Center, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany. alexandra.anton@uniklinik-freiburg.de.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Anton
authors.affiliation: Eye Center, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Heinzelmann
authors.affiliation: Eye Center, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Neß
authors.affiliation: Eye Center, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Lübke
authors.affiliation: Eye Center, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Neuburger
authors.affiliation: Eye Center, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
authors.forename: Jens F
authors.initials: JF
authors.lastname: Jordan
authors.affiliation: Eye Center, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wecker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000379:methods*; D014606:Uveitis, Anterior / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D015867:Uveitis, Intermediate / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014794:Visual Fields / Q000502:physiology
keywords: Minimal invasive glaucoma surgery; Trabectome®; Uveitic glaucoma; Uveitis