Is There a Change in the Quality of Life Comparing the Micro-Invasive Glaucoma Surgery (MIGS) and the Filtration Technique Trabeculectomy in Glaucoma Patients?

Graefes Arch Clin Exp Ophthalmol. 2017 Feb;255(2):351-357. doi: 10.1007/s00417-016-3550-4. Epub 2016 Nov 15.

Abstract

Purpose: This study was conducted to assess the impact on the Quality of Life (QOL) of micro-invasive glaucoma surgery (MIGS: iStent, Trabectome) and a penetrating technique such as Trabeculectomy (TE).

Methods: This study evaluated 88 eyes of 88 open angle glaucoma patients undergoing glaucoma surgery: 43 (mean age 72.8 ± 8.8y, female 59.5 %, male 40.5 %) Trabectome (NeoMedix, Inc., Tustin, CA, USA), 20 (mean age 68.6 ± 16.4y, female 60 %, male 40 %) iStent (Glaucos Corporation, Laguna Hills, CA, USA), and 25 TE patients (mean age 74.2 ± 9.1y female 58.3 %, male 41.7 %). The National Eye Institute-Visual Functioning Questionnaire (VFQ-25) survey was used to assess the QOL at 6 months post surgery. The following 12 QOL parameters were evaluated: general health, ocular pain, general vision, near and distance activities, mental health, social functioning, role difficulties, dependency, driving, color vision, and peripheral vision. Intraocular pressure (IOP), number of topical medications, and visual acuity (VA) were examined preoperatively, 1 day, 6 weeks, 3 months, and 6 months post surgery. Statistical data were calculated using SPSS (v20.0, SPSS, Inc.).

Results: There was no significant difference between TE and MIGS in the quality of life 6 months postoperatively. IOP was significantly lower in TE compared to MIGS at 6 weeks and 3 months postoperatively (p = 0.046 and p = 0.046). Number of medications was significantly decreased in TE compared to MIGS (p < 0.001). A significant difference in VA between TE and MIGS could be assessed at day 1 post-op (p = 0.011).

Conclusion: In this study cohort, the QOL can be maintained by all three surgical techniques. Patients, however, need lower numbers of topical medication in TE, which would impact QOL even though it is not included in the NEI-VFQ-25. The decision of the most appropriate surgical technique should be made by including single QOL categories, IOP and glaucoma medication outcome.

Keywords: Micro-invasive glaucoma surgery; Quality of life; Trabeculectomy; iStent.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Female
  • Filtering Surgery / methods*
  • Follow-Up Studies
  • Glaucoma / physiopathology
  • Glaucoma / psychology
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Minimally Invasive Surgical Procedures / methods*
  • Prospective Studies
  • Quality of Life*
  • Surveys and Questionnaires
  • Time Factors
  • Tonometry, Ocular
  • Trabeculectomy / methods
  • Visual Acuity*