Abstract
We thank Dr Sekhar and Associates for their interest in our article. 1 Gedde S.J. Schiffman J.C. Feuer W.J. et al. Three-year follow-up of the Tube Versus Trabeculectomy Study. Am J Ophthalmol. 2009; 148: 670-684 Abstract Full Text Full Text PDF PubMed Scopus (309) Google Scholar Failure in the Tube Versus Trabeculectomy (TVT) Study was prospectively defined as inadequate intraocular pressure (IOP) reduction (IOP > 21 mm Hg or not reduced by 20%), persistent hypotony (IOP ≤ 5 mm Hg), reoperation for glaucoma, or loss of light perception vision. 2 Gedde S.J. Schiffman J.C. Feuer W.J. et al. The Tube Versus Trabeculectomy Study: Design and baseline characteristics of study patients. Am J Ophthalmol. 2005; 140: 275-287 Abstract Full Text Full Text PDF PubMed Scopus (125) Google Scholar The cumulative probability of failure at 3 years using Kaplan-Meier survival analysis was 15.1% in the tube group and 30.7% in the trabeculectomy group (P = .010; HR = 2.2; 95% CI = 1.2-4.1). 1 Gedde S.J. Schiffman J.C. Feuer W.J. et al. Three-year follow-up of the Tube Versus Trabeculectomy Study. Am J Ophthalmol. 2009; 148: 670-684 Abstract Full Text Full Text PDF PubMed Scopus (309) Google Scholar Dr Sekhar and associates suggest that “the greater failure in the trabeculectomy group is attributable to greater number of repeat surgeries in the trabeculectomy group than in the tube group.” In fact, greater numbers of failures were observed in the trabeculectomy group for each of the failure criteria (not just reoperations for glaucoma). 1 Gedde S.J. Schiffman J.C. Feuer W.J. et al. Three-year follow-up of the Tube Versus Trabeculectomy Study. Am J Ophthalmol. 2009; 148: 670-684 Abstract Full Text Full Text PDF PubMed Scopus (309) Google Scholar Although the rate of glaucoma reoperations was not statistically different between the 2 treatment groups, the overall failure rate was significantly higher in the trabeculectomy group compared to the tube group when all reasons for treatment failure were taken into consideration. Three-Year Follow-up of the Tube Versus Trabeculectomy StudyAmerican Journal of OphthalmologyVol. 149Issue 4PreviewThe 3-year results of the Tube Versus Trabeculectomy (TVT) Study have concluded that tube shunt surgery had higher success compared to trabeculectomy with mitomycin C, and the incidence of complications was greater in the trabeculectomy group.1 The accompanying editorial states that “success rates in the tube shunt group must be tempered by jaded cynicism.”2 We would like to explore the possibility that the study design and the reporting of the results are biased in favor of tube implant. Full-Text PDF
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