Abstract
Objective: To study intraocular pressure (IOP) reduction after trabeculectomy compared with antiglaucoma medications in open angle glaucoma, including complications and evaluate the effect on quality of life and cost-effectiveness between two arms. Methods: This is a randomized controlled trial study that divided patients into 2 groups to receive trabeculectomy or antiglaucoma medications and analyze the clinical outcomes, quality of life and cost-effectiveness at 4 and 12 months. Results: There were 38 enrollment subjects, 18 eyes in trabeculectomy (Trab) group and 20 eyes in medication (Med) group. At baseline, mean (SD) IOP in Trab and Med groups were 25.86 (8.80) mmHg and 27.48 (9.85) mmHg, respectively. At 4 months, there were 17 and 18 eyes remained in Trab and Med groups. Mean IOP reduction (SD) were 19.29 (7.48) mmHg (38.67%) and 10.91 (5.51) mmHg (22.50%) in Trab and Med groups, respectively. The quality of life was assessed using visual function questionnaire-28 and found that Med group had better quality of life than Trab group at 1 year (p = 0.002). However, the results were different since baseline. The total cost was not different between 2 groups at 4 months and 1 year (p = 0.08 and 0.09). Conclusion: Trabeculectomy is more powerful than medications in IOP reduction with acceptable complications at 4 months and 1 year. The cost in Trab group was higher with similar quality of life. However, the sample size in this study is not enough, even after the recruitment strategy was modified. And therefore, may affect the final result. Further study: Evaluation of the outcomes between trabeculectomy and medications is still needed to be addressed. Gathering information about cost from hospital database in combination with an estimation of other expenses may be helpful.
