A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy

Juliane Matlach,1,* Matthias Hipp,1,* Martin Wagner,2,3 Peter U Heuschmann,2,3 Thomas Klink,1 Franz Grehn11Department of Ophthalmology, 2Institute of Clinical Epidemiology and Biometry, 3Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany*These authors co...

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Autores principales:	Matlach J, Hipp M, Wagner M, Heuschmann PU, Klink T, Grehn F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/f5c91e9f56c348c5ad6886dec90fbc63
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spelling	oai:doaj.org-article:f5c91e9f56c348c5ad6886dec90fbc632021-12-02T05:55:39ZA comparative study of a modified filtering trabeculotomy and conventional trabeculectomy1177-5483https://doaj.org/article/f5c91e9f56c348c5ad6886dec90fbc632015-03-01T00:00:00Zhttp://www.dovepress.com/a-comparative-study-of-a-modified-filtering-trabeculotomy-and-conventi-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Juliane Matlach,1,* Matthias Hipp,1,* Martin Wagner,2,3 Peter U Heuschmann,2,3 Thomas Klink,1 Franz Grehn11Department of Ophthalmology, 2Institute of Clinical Epidemiology and Biometry, 3Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany*These authors contributed equally to this workPurpose: The objective of the study reported here was to evaluate the outcome of a modified filtering trabeculotomy (FTO) without iridectomy in open-angle glaucoma compared with that of conventional trabeculectomy (trab).Patients and methods: Thirty eyes of 30 patients who underwent modified FTO were prospectively followed for 1 year and were compared with 87 conventional trab patients (87 eyes), matched for age and preoperative intraocular pressure (IOP). The FTO procedure consisted of a deep sclerectomy and trabeculotomy preserving the trabeculo-Descemet membrane, without iridectomy. Main outcome measures were complete success (IOP <18 mmHg and >/=30% IOP reduction, without medication), IOP, visual acuity, medication, complications, and subsequent surgeries.Results: In the conventional trab group, the median preoperative IOP was 23.0 mmHg (interquartile range 20.0–27.0) with 3.0 (2.0–3.0) medications, compared with 23.0 mmHg (20.0–27.0) and 3.0 (2.8–4.0) in the modified FTO group. Median postoperative IOP at 12 months was 12.0 mmHg (10.0–13.0) in the conventional trab and 11.0 mmHg (8.0–14.0) in the modified FTO group (P=0.3). The complete success rate at 1 year was 83.1% and 79.3% in the conventional trab group and modified FTO group, respectively (P=0.8). The complications hypotony (20.7%, 24.1%), choroidal detachment (2.3%, 10.3%), and bleb scarring (17.2%, 13.8%), were present in the conventional trab group and modified FTO group, respectively.Conclusion: The outcomes of reduced IOP and medications in the FTO group were not different to those in the conventional trab group over 1 year, but some complications were more often seen with the modified FTO technique. The new filtration trabeculotomy, however, has the advantage of avoiding iridectomy, thus reducing the risk of cataract formation, and may result in the development of more favorable blebs by controlling the flow over two resistance levels.Keywords: glaucoma surgery, open-angle glaucoma, outflow resistance, iridectomy, trabeculectomyMatlach JHipp MWagner MHeuschmann PUKlink TGrehn FDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 483-492 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Matlach J Hipp M Wagner M Heuschmann PU Klink T Grehn F A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy
description	Juliane Matlach,1,* Matthias Hipp,1,* Martin Wagner,2,3 Peter U Heuschmann,2,3 Thomas Klink,1 Franz Grehn11Department of Ophthalmology, 2Institute of Clinical Epidemiology and Biometry, 3Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany*These authors contributed equally to this workPurpose: The objective of the study reported here was to evaluate the outcome of a modified filtering trabeculotomy (FTO) without iridectomy in open-angle glaucoma compared with that of conventional trabeculectomy (trab).Patients and methods: Thirty eyes of 30 patients who underwent modified FTO were prospectively followed for 1 year and were compared with 87 conventional trab patients (87 eyes), matched for age and preoperative intraocular pressure (IOP). The FTO procedure consisted of a deep sclerectomy and trabeculotomy preserving the trabeculo-Descemet membrane, without iridectomy. Main outcome measures were complete success (IOP <18 mmHg and >/=30% IOP reduction, without medication), IOP, visual acuity, medication, complications, and subsequent surgeries.Results: In the conventional trab group, the median preoperative IOP was 23.0 mmHg (interquartile range 20.0–27.0) with 3.0 (2.0–3.0) medications, compared with 23.0 mmHg (20.0–27.0) and 3.0 (2.8–4.0) in the modified FTO group. Median postoperative IOP at 12 months was 12.0 mmHg (10.0–13.0) in the conventional trab and 11.0 mmHg (8.0–14.0) in the modified FTO group (P=0.3). The complete success rate at 1 year was 83.1% and 79.3% in the conventional trab group and modified FTO group, respectively (P=0.8). The complications hypotony (20.7%, 24.1%), choroidal detachment (2.3%, 10.3%), and bleb scarring (17.2%, 13.8%), were present in the conventional trab group and modified FTO group, respectively.Conclusion: The outcomes of reduced IOP and medications in the FTO group were not different to those in the conventional trab group over 1 year, but some complications were more often seen with the modified FTO technique. The new filtration trabeculotomy, however, has the advantage of avoiding iridectomy, thus reducing the risk of cataract formation, and may result in the development of more favorable blebs by controlling the flow over two resistance levels.Keywords: glaucoma surgery, open-angle glaucoma, outflow resistance, iridectomy, trabeculectomy
format	article
author	Matlach J Hipp M Wagner M Heuschmann PU Klink T Grehn F
author_facet	Matlach J Hipp M Wagner M Heuschmann PU Klink T Grehn F
author_sort	Matlach J
title	A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy
title_short	A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy
title_full	A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy
title_fullStr	A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy
title_full_unstemmed	A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy
title_sort	comparative study of a modified filtering trabeculotomy and conventional trabeculectomy
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/f5c91e9f56c348c5ad6886dec90fbc63
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A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy

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