Mid-Term Results of Ab Interno Trabeculectomy among Japanese Glaucoma Patients

Background: The evaluation of ab interno trabeculectomy, referred to as trabectome(R), among Japanese patients is insufficient. Subjects and methods: Japanese patients who underwent trabectome(R) at the University of Yamanashi Hospital were included. The investigated parameters were intraocular pressure (IOP), best corrected visual acuity, glaucoma medications, visual field, and corneal endothelial cell density. The success rate and its associated factors were investigated. Results: A total of 250 eyes from 197 patients were enrolled. The trabectome(R) significantly reduced IOP and glaucoma medications up to 48 months. Concomitant cataract extraction enhanced the reduction in IOP and glaucoma medications up to 42 months. At 36 months postoperatively, 40.8% satisfied IOP of the same or less than 18 mmHg or more than a 20% IOP reduction with the same or less use of glaucoma medications as preoperatively. Preoperative IOP and combined cataract extraction were significantly associated with the success rate. The trabectome(R) alone did not show a significant reduction in corneal endothelial cells. Eyes with postoperative transient IOP elevation and removal of anterior chamber hemorrhage were 11.2% and 1.2%, respectively. Twenty-four eyes (9.6%) underwent additional glaucoma surgeries. Conclusions: The trabectome(R) could be considered an effective and safe surgery. Compared to trabectome(R) alone, combined cataract surgery was superior in lowering IOP and reducing glaucoma medications.