The Tube Versus Trabeculectomy Study

Interpretation of results and application to clinical practice

Steven J Gedde, Kuldev Singh, Joyce C. Schiffman, William J Feuer

Research output: Contribution to journalArticle

79 Citations (Scopus)

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 C (MMC) in eyes with previous cataract and/or failed glaucoma surgery. This article interprets results from the TVT Study and applies them to clinical practice. RECENT FINDINGS: Both tube-shunt surgery and trabeculectomy with MMC produced intraocular pressure (IOP) reduction to the low teens throughout the 5-year duration of the study. Tube-shunt surgery was associated with use of more glaucoma medications than trabeculectomy with MMC during the first 2 years of the study, but medical therapy equalized with longer follow-up. Trabeculectomy with MMC had higher rates of surgical failure and reoperation for glaucoma compared with tube-shunt surgery. Vision loss occurred at a similar rate with the two surgical procedures. Early complications were more frequent after trabeculectomy with MMC relative to tube-shunt surgery, but both procedures had similar rates of late postoperative complications and serious complications. SUMMARY: Tube-shunt surgery and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients who have undergone prior cataract and/or failed filtering surgery. Results of the TVT Study support the expanding use of tube shunts beyond refractory glaucomas.

Original languageEnglish
Pages (from-to)118-126
Number of pages9
JournalCurrent Opinion in Ophthalmology
Volume23
Issue number2
DOIs
StatePublished - Mar 1 2012

Fingerprint

Trabeculectomy
Mitomycin
Glaucoma
Cataract
Filtering Surgery
Intraocular Pressure
Reoperation
Randomized Controlled Trials
Safety

Keywords

  • Glaucoma surgery
  • Trabeculectomy
  • Tube shunt

ASJC Scopus subject areas

  • Ophthalmology

Cite this

The Tube Versus Trabeculectomy Study : Interpretation of results and application to clinical practice. / Gedde, Steven J; Singh, Kuldev; Schiffman, Joyce C.; Feuer, William J.

In: Current Opinion in Ophthalmology, Vol. 23, No. 2, 01.03.2012, p. 118-126.

Research output: Contribution to journalArticle

Gedde, Steven J ; Singh, Kuldev ; Schiffman, Joyce C. ; Feuer, William J. / The Tube Versus Trabeculectomy Study : Interpretation of results and application to clinical practice. In: Current Opinion in Ophthalmology. 2012 ; Vol. 23, No. 2. pp. 118-126.
@article{d8c6e7793d134e8a87e2356c5686725e,
title = "The Tube Versus Trabeculectomy Study: Interpretation of results and application to clinical practice",
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 C (MMC) in eyes with previous cataract and/or failed glaucoma surgery. This article interprets results from the TVT Study and applies them to clinical practice. RECENT FINDINGS: Both tube-shunt surgery and trabeculectomy with MMC produced intraocular pressure (IOP) reduction to the low teens throughout the 5-year duration of the study. Tube-shunt surgery was associated with use of more glaucoma medications than trabeculectomy with MMC during the first 2 years of the study, but medical therapy equalized with longer follow-up. Trabeculectomy with MMC had higher rates of surgical failure and reoperation for glaucoma compared with tube-shunt surgery. Vision loss occurred at a similar rate with the two surgical procedures. Early complications were more frequent after trabeculectomy with MMC relative to tube-shunt surgery, but both procedures had similar rates of late postoperative complications and serious complications. SUMMARY: Tube-shunt surgery and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients who have undergone prior cataract and/or failed filtering surgery. Results of the TVT Study support the expanding use of tube shunts beyond refractory glaucomas.",
keywords = "Glaucoma surgery, Trabeculectomy, Tube shunt",
author = "Gedde, {Steven J} and Kuldev Singh and Schiffman, {Joyce C.} and Feuer, {William J}",
year = "2012",
month = "3",
day = "1",
doi = "10.1097/ICU.0b013e32834ff2d1",
language = "English",
volume = "23",
pages = "118--126",
journal = "Current Opinion in Ophthalmology",
issn = "1040-8738",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The Tube Versus Trabeculectomy Study

T2 - Interpretation of results and application to clinical practice

AU - Gedde, Steven J

AU - Singh, Kuldev

AU - Schiffman, Joyce C.

AU - Feuer, William J

PY - 2012/3/1

Y1 - 2012/3/1

N2 - 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 C (MMC) in eyes with previous cataract and/or failed glaucoma surgery. This article interprets results from the TVT Study and applies them to clinical practice. RECENT FINDINGS: Both tube-shunt surgery and trabeculectomy with MMC produced intraocular pressure (IOP) reduction to the low teens throughout the 5-year duration of the study. Tube-shunt surgery was associated with use of more glaucoma medications than trabeculectomy with MMC during the first 2 years of the study, but medical therapy equalized with longer follow-up. Trabeculectomy with MMC had higher rates of surgical failure and reoperation for glaucoma compared with tube-shunt surgery. Vision loss occurred at a similar rate with the two surgical procedures. Early complications were more frequent after trabeculectomy with MMC relative to tube-shunt surgery, but both procedures had similar rates of late postoperative complications and serious complications. SUMMARY: Tube-shunt surgery and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients who have undergone prior cataract and/or failed filtering surgery. Results of the TVT Study support the expanding use of tube shunts beyond refractory glaucomas.

AB - 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 C (MMC) in eyes with previous cataract and/or failed glaucoma surgery. This article interprets results from the TVT Study and applies them to clinical practice. RECENT FINDINGS: Both tube-shunt surgery and trabeculectomy with MMC produced intraocular pressure (IOP) reduction to the low teens throughout the 5-year duration of the study. Tube-shunt surgery was associated with use of more glaucoma medications than trabeculectomy with MMC during the first 2 years of the study, but medical therapy equalized with longer follow-up. Trabeculectomy with MMC had higher rates of surgical failure and reoperation for glaucoma compared with tube-shunt surgery. Vision loss occurred at a similar rate with the two surgical procedures. Early complications were more frequent after trabeculectomy with MMC relative to tube-shunt surgery, but both procedures had similar rates of late postoperative complications and serious complications. SUMMARY: Tube-shunt surgery and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients who have undergone prior cataract and/or failed filtering surgery. Results of the TVT Study support the expanding use of tube shunts beyond refractory glaucomas.

KW - Glaucoma surgery

KW - Trabeculectomy

KW - Tube shunt

UR - http://www.scopus.com/inward/record.url?scp=84857236207&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857236207&partnerID=8YFLogxK

U2 - 10.1097/ICU.0b013e32834ff2d1

DO - 10.1097/ICU.0b013e32834ff2d1

M3 - Article

VL - 23

SP - 118

EP - 126

JO - Current Opinion in Ophthalmology

JF - Current Opinion in Ophthalmology

SN - 1040-8738

IS - 2

ER -