What is the efficacy of drainage implant surgery in the treatment of primary open-angle glaucoma (POAG)?

Updated: Mar 16, 2020
  • Author: Kristin Schmid Biggerstaff, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Answer

The Tube versus Trabeculectomy Study has been undertaken to see if glaucoma tube shunt surgery may actually be a viable first-line alternative to (or even surpass) trabeculectomy surgery.

One-year data have shown nonvalved tube shunt surgery was more likely to maintain IOP control and to avoid persistent hypotony or reoperation for glaucoma than trabeculectomy at 1 year, although both procedures produced similar IOP reduction. Failure rates during 5 years of follow-up were 29.8% in the tube group and 46.9% in the trabeculectomy group.

Less supplemental medical therapy has been needed in the trabeculectomy group at 1 year; however, at 5 years, there was no difference.

The incidence of postoperative complications at 1 year was higher in the trabeculectomy group. Serious complications resulting in reoperation and/or vision loss occurred with similar frequency in both groups at 1 year. The reoperation rate for IOP reduction was higher in the trabeculectomy group than in the tube group at 5 years.


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