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TVT - Tube vs Trab Study

The Tube vs Trab (TVT) study was a randomized controlled trial of 212 patients with previous trabeculectomy or cataract surgery, now in need of additional surgery for glaucoma – these patients received either trabeculectomy or tube shunt. At 5 years, the following outcomes were similar for tube vs trab: IOP: 14.4 mmHg vs 12.6 mmHg (p=0.12) Reduction in number of gtt: 1.4 vs 1.2 (p=0.23) But tubes seem to be safer with fewer complications vs trab: Failure rate: 30% vs 47% (HR=2.15, p=0.002) Reoperation rate: 9% vs 29% (p=0.025) However, the tables turn a bit during the Primary Tube vs Trab (PTVT) Study because trabs seem to be more effective for initial surgery compared to tube for the following (tube vs trab): Final IOP: 14.0 vs 12.1 (p.008) Number of post-op gtt: 2.1 vs 1.2 (p=0.0001) For PRIMARY glaucoma surgery, TRABS WERE MORE EFFECTIVE and TUBES WERE SAFER. For SECONDARY glaucoma surgery, both surgeries were equally effective but TUBES WERE SAFER. TVT: https://pubmed.ncbi.nlm.nih.gov/22245... PTVT: https://pubmed.ncbi.nlm.nih.gov/31727... For this video, the Ophthalminute Team would like to give a special thanks to Amin Karadaghy (PGY-1 at the University of Kansas) for giving particularly helpful suggestions which made this video better.