Evaluation of Trabectome in Open-Angle Glaucoma

Purpose: To evaluate the outcomes of Trabectome, a surgical device that ablates an arc of trabecular meshwork, in Japanese glaucoma patients. Patients and Methods: Trabectome surgeries were performed on 80 eyes of 69 adult Japanese patients (age range, 14 to 89 y; 50 male and 30 female patients) with or without previous surgery or laser treatment. Goldmann applanation intraocular pressure (IOP), adjunctive medications, corneal endothelial cell density, and best corrected visual acuity were measured before and after surgery. Intraoperative and postoperative adverse events were also tabulated. Results: Mean preoperative IOP of 26.6 +/- 8.1 mm Hg (range, 16 to 50 mm Hg) decreased to a mean postoperative IOP of 17.4 +/- 3.4 mm Hg (range, 9 to 24 mm Hg) (28.7% reduction) by 6 months after surgery (N = 53). Adjunctive medication decreased from 4.0 +/- 1.4 to 2.3 +/- 1.2 at 6 months after surgery. Intraoperative blood reflux occurred in 100% of cases. No vision-threatening complications such as choroidal effusion, choroidal hemorrhage, or infection occurred. Thirteen cases (16.3%) received surgical reintervention and 1 case received cataract extraction during follow-up. No significant endothelial cell density change was recognized. Conclusion: Trabectome is an effective and safe alternative to traditional glaucoma surgeries with the expectation of approximately a 30% decrease in IOP through 6 months postoperatively.