Review of results from the tube versus trabeculectomy study

Steven Gedde, Douglas Anderson, Donald Budenz, Madeline Del Calvo, Ivette DePool, Francisco Fantes, David Greenfield, Jessica Hochberg, Elizabeth Hodapp, Richard Lee, Alexia Marcellino, Paul Palmberg, Richard Parrish, Leon Herndon, Pratap Challa, Cecile Santiago-Turla, Darrell WuDunn, Geoffrey Emerick, Dale Heuer, Alexander KentCarol Bradham, Lisa Langdale, Keith Barton, Francesca Amalfitano, Poornima Rai, Paul Sidoti, Amy Gedal, James Luayon, Roma Ovase, Katy Tai, Quang Nguyen, Steven Shields, Kevin Anderson, Frank Moya, James Brandt, Michele Lim, Marilyn Sponzo, Mark Sherwood, Gregory Skuta,, Jason Jobson, Lisa Ogilbee, Adam Reynolds, Steven Sarkisian, Rohit Varma, Robert Feldman, Laura Baker, Nicholas Bell, Jo Lene Carranza, Brian Francis, Bruce Prum, Todd Perkins,, Paul Kaufman, Barbara Soderling, William Feuer, Luz Londono, Joyce Schiffman, Wei Shi, Philip Chen, Kuldev Singh, George Spaeth, Martha Wright, Gregory Skuta

Research output: Contribution to journalReview articlepeer-review

49 Scopus citations

Abstract

Purpose of review: The Tube Versus Trabeculectomy (TVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube-shunt surgery to trabeculectomy with mitomycin (MMC) in eyes with previous cataract and/or unsuccessful glaucoma surgery. This article reviews published results from the TVT Study. Recent findings: Tube-shunt surgery had a higher success rate than trabeculectomy with MMC during the first 3 years of follow-up. Trabeculectomy with MMC produced greater intraocular pressure (IOP) reduction in the early postoperative period compared with tube-shunt placement, but similar IOPs were observed after 3 months. Tube-shunt surgery was associated with greater use of adjunctive-medical therapy than trabeculectomy with MMC during the first 2 years of the study, but no difference in medication use was seen at 3 years. The incidence of postoperative complications was higher after trabeculectomy with MMC compared with tube-shunt surgery, but serious complications associated with vision loss and/or reoperation developed with similar frequency after both surgical procedures. No difference in the rate of vision loss was present following trabeculectomy with MMC and tube-shunt surgery after 3 years of follow-up. Cataract progression was common, but occurred with similar frequency with both procedures. Summary: Intermediate-term results of the TVT Study support the expanded use of tube shunts beyond refractory glaucomas. Tube-shunt surgery is an appropriate surgical option in patients who have undergone prior cataract and/or unsuccessful filtering surgery.

Original languageEnglish (US)
Pages (from-to)123-128
Number of pages6
JournalCurrent opinion in ophthalmology
Volume21
Issue number2
DOIs
StatePublished - Mar 1 2010

Keywords

  • Glaucoma surgery
  • Trabeculectomy
  • Tube shunt

ASJC Scopus subject areas

  • Ophthalmology

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