Success Rates of Trabeculotomy for Steroid-Induced Glaucoma: A Comparative, Multicenter, Retrospective Cohort Study

Purpose To evaluate the surgical outcomes of trabeculotomy for steroid-induced glaucoma. Design Multicenter, retrospective cohort study. Methods At 17 Japanese clinical centers, 121 steroid-induced glaucoma patients who underwent trabeculotomy between 1997 and 2006 were reviewed. Surgical failure wa...

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Bibliographic Details
Published in:American journal of ophthalmology 2011-06, Vol.151 (6), p.1047-1056.e1
Main Authors: Iwao, Keiichiro, Inatani, Masaru, Tanihara, Hidenobu
Format: Article
Language:English
Subjects:
Adult
Alkylating Agents - administration & dosage
Biological and medical sciences
Cohort Studies
Female
Glaucoma
Glaucoma and intraocular pressure
Glaucoma, Open-Angle - chemically induced
Glaucoma, Open-Angle - physiopathology
Glaucoma, Open-Angle - surgery
Glucocorticoids - adverse effects
Hospitals
Humans
Intraocular Pressure - physiology
Male
Medical sciences
Middle Aged
Miscellaneous
Mitomycin
Ophthalmology
Probability
Retrospective Studies
Studies
Surgical outcomes
Therapy
Trabeculectomy
Treatment Outcome
Visual Acuity - physiology
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Summary:Purpose To evaluate the surgical outcomes of trabeculotomy for steroid-induced glaucoma. Design Multicenter, retrospective cohort study. Methods At 17 Japanese clinical centers, 121 steroid-induced glaucoma patients who underwent trabeculotomy between 1997 and 2006 were reviewed. Surgical failure was defined by the need for additional glaucoma surgery, deterioration of visual acuity to no light perception, or intraocular pressure ≥21 mm Hg (criterion A) and ≥18 mm Hg (criterion B). Surgical outcomes were compared with those of 108 primary open-angle glaucoma (POAG) patients who underwent trabeculotomy and 42 steroid-induced glaucoma patients who underwent trabeculectomy. Prognostic factors for failure were evaluated using the Cox proportional hazards model. Results The probabilities of success at 3 years for trabeculotomy for steroid-induced glaucoma vs trabeculotomy for POAG was 78.1% vs 55.8% for criterion A ( P = .0008) and 56.4% vs 30.6% for criterion B ( P < .0001), respectively. At 3 years, the success of trabeculotomy for steroid-induced glaucoma was comparable to trabeculectomy for steroid-induced glaucoma for criterion A (83.8%; P = .3636), but lower for criterion B (71.6%; P = .0352). Prognostic factors for failure of trabeculotomy for steroid-induced glaucoma were previous vitrectomy (relative risk [RR] = 5.340; P = .0452 on criterion A, RR = 3.898; P = .0360 for criterion B) and corticosteroid administration other than ocular instillation (RR = 2.752; P = .0352 for criterion B). Conclusions Trabeculotomy is effective for controlling intraocular pressure
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2010.11.028