title: Short-term evaluation of Trabectome surgery performed on Japanese patients with open-angle glaucoma.
abstract: OBJECTIVE
  To evaluate the short-term results of Trabectome surgery performed on Japanese patients.
  
  
  METHODS
  Retrospective observational study. Trabectome surgery was performed on 117 eyes from 101 patients at Kitasato University Hospital from December 2010 to June 2013, involving 48 eyes with primary open-angle glaucoma (POAG), 62 eyes with secondary open-angle glaucoma (SOAG), and 7 eyes with developmental glaucoma. Trabectome surgery alone was performed on 34 phakic eyes (the phakic group) and 35 pseudophakic eyes (the pseudophakic group), and Trabectome surgery combined with phacoemulsification (the combined surgery group) was performed on 48 eyes. The main outcomes assessed were intraocular pressure (IOP), number of IOP-lowering medications, and success probabilities using Kaplan-Meier life-table analyses. Failure risk factors were identified using the Cox proportional hazards ratio.
  
  
  RESULTS
  In all cases, after a mean follow-up of 18.5 ± 13.5 months, IOP was reduced from 31.6 ± 9.9 (SD) mmHg using 5.0 ± 1.7 medications to 16.4 ± 5.4 mmHg using 3.8 ± 1.8 medications. One year after surgery, IOP was reduced from 29.4 ± 7.8 to 16.1 ± 3.8 mmHg in POAG, from 33.6 ± 11.1 to 14.7 ± 2.9 mmHg in SOAG, from 33.0 ± 10.2 to 15.7 ± 3.3 mmHg in the phakic group, from 32.6 ± 9.3 to 15.3 ± 3.0 mmHg in the pseudophakic group, and from 29.9 ± 10.0 to 15.2 ± 3.0 mmHg in the combined surgery group. There were no statistically significant differences in IOP at each measurement point, either between POAG and SOAG or among the three procedure subtypes. The POAG and SOAG success rates at 12 months using postoperative IOP ≤ 21 mmHg and ≥20 % reduction in baseline as criteria were 53.9 and 77.2 %, respectively (p = 0.024, log-rank test). Twenty-one eyes (17.9 %) needed additional trabeculectomy. None of the univariate and multivariate risk factors for failure were detected.
  
  
  CONCLUSIONS
  Trabectome surgery is safe and effective for Japanese patients whose target IOP is 18 mmHg or above. However, it is necessary to carefully consider Trabectome surgery for advanced POAG cases.
authors.affiliation: Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan. nshoji@kitasato-u.ac.jp.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shoji
authors.affiliation: Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kasahara
authors.affiliation: Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Iijima
authors.affiliation: Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan.
authors.forename: Sonoko
authors.initials: S
authors.lastname: Tatsui
authors.affiliation: Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Matsumura
authors.affiliation: Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan.
authors.forename: Kimiya
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000502:physiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D014130:Trabeculectomy / Q000295:instrumentation*; D055815:Young Adult
keywords: Intraocular pressure; Open-angle glaucoma; Success rate; Trabectome surgery; Trabeculotomy