title: [Trabeculectomy Ab Interno in Primary Open Angle Glaucoma and Exfoliative Glaucoma].
abstract: BACKGROUND
  To assess the outcome of routine trabectomy surgery in the treatment of primary (POAG) and secondary open angle glaucoma.
  
  
  METHODS
  296 eyes of 296 patients with diagnosed open angle glaucoma and exfoliative glaucoma were analysed from June 2012 until June 2014. IOP readings (intraocular pressure) and the number of antiglaucoma medications was evaluated at every follow-up visit. For statistical analysis, 4 study cohorts were built (cohort 1 = trabectomy in POAG, cohort 2 = trabectomy in exfoliative glaucoma (PEX), cohort 3 = trabectomy + IOL in POAG, cohort 4 = trabectomy + IOL in PEX glaucoma).
  
  
  RESULTS
  Mean IOP before trabectomy surgery was 19.8 ± 5.9 mmHg and 23.7 ± 9.5 mmHg in cohorts 1 and 2, respectively. At 1 year follow-up, IOP was reduced to normal level for cohorts 1 and 2 (14.8 ± 3.2 mmHg (p = 0.001) and 14.0 ± 3.3 mmHg (p = 0.046), respectively). The number of topical antiglaucoma medications changed to 2.1 ± 1.2 (p = 0.004) and 2.4 ± 1.2, respectively (p = 0.593) at one year follow-up, respectively, for POAG and exfoliative glaucoma. In study cohort 3 and 4, mean IOP before trabectomy surgery was 19.2 ± 4.0 mmHg and 23.2 ± 9.2 mmHg, respectively. At 1 year follow-up, IOP was reduced to normal levels in cohorts 3 and 4 (11.8 ± 3.1 mmHg (p < 0.01) and 12.6 ± 1.1 mmHg, respectively (p = 0.043)); the number of topical antiglaucoma medications changed to 2.3 ± 1.4 (p = 0.469) and 1.4 ± 0.8, respectively, (p = 0.102) at 1 year follow-up. A significant difference in IOP reduction could be demonstrated in POAG between the trabectomy + IOL group and the trabectomy cohort 1 year postoperative (p = 0.017); in the PEX trabectomy + IOL versus PEX trabectomy cohort no statistically significant difference (p = 0.678) could be demonstrated. No serious postoperative complications were recorded.
  
  
  CONCLUSIONS
  Trabectomy surgery seemed to be a reliable and effective tool for the management of mild and moderate primary and secondary open angle glaucoma with uncontrolled IOP in daily routine. One year follow-up showed a significant reduction in intraocular pressure in all cohorts.
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Pahlitzsch
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin.
authors.forename: J
authors.initials: J
authors.lastname: Gonnermann
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin.
authors.forename: A-K B
authors.initials: AK
authors.lastname: Maier
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin.
authors.forename: N
authors.initials: N
authors.lastname: Torun
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin.
authors.forename: E
authors.initials: E
authors.lastname: Bertelmann
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin.
authors.forename: A M
authors.initials: AM
authors.lastname: Joussen
authors.affiliation: Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Klamann
mesh_terms: D000368:Aged; D004867:Equipment Design; D019544:Equipment Failure Analysis; D017889:Exfoliation Syndrome / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity