Tube Versus Trabeculectomy IRIS registry 1-Year Composite Outcome Analysis with Comparisons to the Randomized Controlled Trial

Elizabeth A. Vanner, Catherine Q. Sun, Matthew J. McSoley, Patrice J. Persad, William J. Feuer, Flora Lum, Scott P. Kelly, Richard K. Parrish, Ta C. Chang, Steven J. Gedde

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study compared 1-year results for the composite treatment outcome from the Tube Versus Trabeculectomy (TVT) randomized controlled trial (RCT) to those from an IRIS (Intelligent Research In Sight) study registry cohort of analogous eyes. Design: Retrospective clinical study with comparison to an RCT. Methods: Subjects’ eyes in the IRIS registry received either a glaucoma drainage implant (tube) or underwent trabeculectomy after a previous trabeculectomy and/or cataract extraction with data for 1-year follow-up analyses. Outcome: eyes were classified as failing if they had hypotony (intraocular pressure [IOP] <5 mm Hg) or inadequate IOP control (IOP >21 mm Hg or not reduced at least 20% below baseline) on 2 consecutive follow-up visits after 3 months, a reoperation for glaucoma, or no light perception vision and as successful otherwise. Failure risk was compared by treatment, demographic, and clinical variables and was compared to analogous failure risks from the TVT RCT. Results: The TVT IRIS registry cohort included 419 eyes, 236 tube eyes (56.3%) and 183 trabeculectomy eyes (43.7%). In this cohort, there were no significant failure risk differences (12.3% for tube eyes and 16.4% for trabeculectomy eyes; P = .231). Comparing the studies, there was a significantly greater risk of failure in the TVT IRIS registry tube eyes than in the TVT RCT tube eyes (3.8%; P <.001). Reasons for treatment failure included reoperations for glaucoma (none in the TVT RCT at 1 year). Conclusions: Our results were different from those in the TVT RCT. Possible reasons include non-Baerveldt tubes, greater severity among tube eyes, and practice patterns that reflect real-world data, which are different than those in RCTs.

Original languageEnglish (US)
Pages (from-to)87-99
Number of pages13
JournalAmerican journal of ophthalmology
Volume227
DOIs
StatePublished - Jul 2021
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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