Eyeworld

Five-year results of the Trabeculectomy vs. Tube Study I n recent years, experts have de- bated whether trabeculectomy is the optimal first-line surgical procedure or whether tube- shunt implantation is prefer- able. The Trabeculectomy vs. Tube (TVT) Study was designed to address this important clinical question. At the 2011 annual meeting of the American Glaucoma Society in Dana Point, Calif., the 5-year safety and efficacy results of the TVT Study were presented and discussed. TVT design "The TVT Study enrolled subjects who had previously undergone ei- ther uncomplicated phacoemulsifi- cation, failed trabeculectomy, or both," said Steven J. Gedde, M.D., Bascom Palmer Eye Institute, Uni- versity of Miami. "Overall, 212 sub- jects were enrolled at 17 centers. The mean baseline IOP was approxi- mately 25 mm Hg using just over three medications on average. Sub- jects were randomly assigned to undergo trabeculectomy with mitomycin c or implantation of a Baerveldt device [Abbott Medical Optics, Santa Ana, Calif.] and fol- lowed for up to 5 years." Trabeculectomies were per- formed in standard fashion using mitomycin c 0.4 mg/mL for 4 min- utes, he said, and the 350-mm 2 Baerveldt implant was utilized. "At each visit, subjects were as- sessed for ongoing success or failure status," he explained. Failure was de- clared if IOP exceeded 21 mm Hg, failed to remain at least 20% below pre-op baseline, or fell to 5 mm Hg or below, or if the subject required an additional operation or vision de- clined to loss of light perception. TVT efficacy Over the first 3 months after surgery, October 2011 by Tony Realini, M.D., M.P.H. Optimizing the surgical management of glaucoma This is all we do. So, yeah, you could say there's a little pressure to make it awesome. Call or visit us online. 888.905.7770 2975 Brother Blvd | Bartlett TN 38133 ODYSSEYMED.COM The Odyssey Parasol ® Punctal Occluder Easy to insert Simple sizing Guaranteed retention* *Certain conditions apply. 26146_Odyssey Medical ad_EyeWorld.indd 1 6/6/11 1:03 PM continued on page 86 84-88 Glaucoma_EW October 2011-DL2_Layout 1 9/29/11 4:10 PM Page 85

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