title: Steroid-induced glaucoma treated with trabecular ablation in a matched comparison with primary open-angle glaucoma.
abstract: BACKGROUND
  To evaluate the outcomes of trabectome-mediated ab interno trabeculectomy in patients with steroid-induced glaucoma (SIG).
  
  
  METHODS
  A retrospective, observational cohort study performed in the Department of Ophthalmology, University of Pittsburgh Medical Center.
  
  
  METHODS
  The data of 60 patients with SIG and 484 controls with primary open-angle glaucoma (POAG) matched by age, gender and glaucoma index were collected from the Trabectome Study Group database.
  
  
  METHODS
  Reduction of intraocular pressure (IOP) and medications were compared between POAG and SIG by multivariate regression. Kaplan-Meier was used for survival analysis. Success was defined as IOP ≤21 mmHg and at least 20% IOP reduction from baseline for any two consecutive visits after 3 months without secondary glaucoma surgery. Postoperative IOP and number of medications were compared with baseline in the SIG subgroups by the Wilcoxon test.
  
  
  METHODS
  Intraocular pressure reduction and 1-year success rate.
  
  
  RESULTS
  Patients with SIG had a higher baseline IOP (31.4 ± 10.4 vs. 24.1 ± 7.6 mmHg, P < 0.01) and obtained a greater IOP reduction than controls with POAG (48.4% vs. 31.5%, P < 0.01). Multivariate regression showed that patients with SIG had an IOP reduction of 6.7 ± 1.1 mmHg more than those with POAG. Survival rates at 12 months were comparable at 86% in the SIG group and 85% in the POAG group (P = 0.47). Patients with SIG with a high baseline IOP, younger age and advanced glaucoma experienced a larger IOP drop.
  
  
  CONCLUSIONS
  Trabectome appears to be an effective surgical treatment in reducing IOP for patients with SIG.
authors.affiliation: Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Yalong
authors.initials: Y
authors.lastname: Dang
authors.affiliation: Department of Ophthalmology, Loma Linda University Veterans Affairs, Loma Linda, California, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kaplowitz
authors.affiliation: Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.|Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Hardik A
authors.initials: HA
authors.lastname: Parikh
authors.affiliation: Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Pritha
authors.initials: P
authors.lastname: Roy
authors.affiliation: Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Ralitsa T
authors.initials: RT
authors.lastname: Loewen
authors.affiliation: Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Francis
authors.affiliation: Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Nils A
authors.initials: NA
authors.lastname: Loewen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000139:chemically induced / Q000601:surgery*; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000379:methods*; D055815:Young Adult
chemical_list: D005938:Glucocorticoids
keywords: ab interno trabeculectomy; intraocular pressure; primary open-angle glaucoma; steroid-induced glaucoma; trabectome