Minimally invasive surgery with Trabectome for glaucoma

What was the aim of this review?
The aim of this Cochrane Review was to learn if a Trabectome improves the surgical treatment of glaucoma. Cochrane researchers collected and analysed all relevant studies to answer this question and found no completed studies.

Key messages
There are no data comparing Trabectome with other treatments.

What was studied in the review?
Glaucoma is the leading cause of irreversible blindness. In glaucoma the optic nerve at the back of eye is damaged, in many cases because the pressure inside the eye is too high. Doctors can lower the eye pressure by surgery. The Trabectome is a device that could help make this surgery less invasive, which may be safer than standard surgery.

What are the main results of the review?
The review authors did not find any completed studies.

How up-to-date is this review?
The review authors searched for studies published up to 12 May 2016.

Authors' conclusions: 

There is currently no high-quality evidence for the outcomes of ab interno trabecular bypass surgery with Trabectome for open angle glaucoma. Properly designed RCTs are needed to assess the long-term efficacy and safety of this technique.

Read the full abstract...
Background: 

Glaucoma is the leading cause of irreversible blindness. Minimally invasive surgical techniques, such as ab interno trabecular bypass surgery, have been introduced to prevent glaucoma progressing.

Objectives: 

The main objective was to assess the results at two years of ab interno trabecular bypass surgery with Trabectome for open angle glaucoma in comparison to conventional medical, laser, or surgical treatment in terms of efficacy and safety. A secondary objective was to examine the effects of Trabectome surgery in people who have concomitant phacoemulsification in comparison to those who do not have concomitant phacoemulsification.

Search strategy: 

We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2016), EMBASE (January 1980 to May 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 12 May 2016.

Selection criteria: 

We included only randomised controlled trials (RCTs) of ab interno trabecular bypass surgery with Trabectome.

Data collection and analysis: 

We planned to have two review authors independently extract data from reports of included studies using a data collection form.

Main results: 

One randomised controlled trial identified from ClinicalTrials.gov, NCT00901108, met the criteria for inclusion. This study has subsequently been terminated. The ClinicalTrials.gov record indicates that the investigators plan to complete 12 months of follow-up and analysis on 19 participants already recruited into the trial.

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