Motility Disturbances in the Tube Versus Trabeculectomy Study During the First Year of Follow-up

Purpose To describe the preoperative and postoperative motility disturbances encountered in the Tube Versus Trabeculectomy (TVT) Study during the first year of follow-up. Design Multicenter randomized clinical trial. Methods settings: Seventeen clinical centers. population: Patients 18 to 85 years o...

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Bibliographic Details
Published in:American journal of ophthalmology 2009-03, Vol.147 (3), p.458-466
Main Authors: Rauscher, Frederick M, Gedde, Steven J, Schiffman, Joyce C, Feuer, William J, Barton, Keith, Lee, Richard K
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Alkylating Agents - therapeutic use
Biological and medical sciences
Clinical trials
Colleges & universities
Diabetic retinopathy
Diplopia - etiology
Female
Follow-Up Studies
Glaucoma
Glaucoma - surgery
Glaucoma Drainage Implants
Health Insurance Portability & Accountability Act 1996-US
Humans
Incidence
Intraocular Pressure
Male
Medical sciences
Middle Aged
Miscellaneous
Mitomycin - therapeutic use
Motility
Ocular Motility Disorders - etiology
Ophthalmology
Postoperative Complications
Prospective Studies
Risk Factors
Standard deviation
Surgery
Trabeculectomy
Young Adult
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Summary:Purpose To describe the preoperative and postoperative motility disturbances encountered in the Tube Versus Trabeculectomy (TVT) Study during the first year of follow-up. Design Multicenter randomized clinical trial. Methods settings: Seventeen clinical centers. population: Patients 18 to 85 years old who had previous trabeculectomy and/or cataract surgery and uncontrolled glaucoma with intraocular pressure ≥18 mm Hg and ≤40 mm Hg on maximum tolerated medical therapy. interventions: 350-mm2 Baerveldt glaucoma implant or trabeculectomy with mitomycin C (MMC). main outcome measures: Preoperative and postoperative evaluation of ocular motility and diplopia. Results Motility disturbances were detected in 55 patients (28%) at baseline. New-onset persistent diplopia was reported in 5 patients (5%) in the tube group and no patients in the trabeculectomy group at 1 year ( P = .06). A new postoperative motility disturbance developed or worsened in 7 patients (9.9%) in the tube group and no patients in the trabeculectomy group during the first year of follow-up ( P = .005). Postoperative motility disturbances were also associated with increasing age ( P < .001) and right eye surgery ( P = .044). Conclusions Preoperative motility disturbances were common among patients in the TVT Study. New postoperative motility disturbances were more frequent following tube shunt surgery than trabeculectomy with MMC after 1 year of follow-up.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2008.09.019