The Tube Versus Trabeculectomy Study: Interpretation of results and application to clinical practice

Steven Gedde, Douglas Anderson, Donald Budenz, Madeline Del Calvo, Ivette DePool, Francisco Fantes, David Greenfield, Jessica Hochberg, Elizabeth Hodapp, Richard Lee, Alexia Marcellino, Paul Palmberg, Richard Parrish, Leon Herndon, Pratap Challa, Cecile Santiago-Turla, Darrell WuDunn, Geoffrey Emerick, Dale Heuer, Alexander KentCarol Bradham, Lisa Langdale, Keith Barton, Francesca Amalfitano, Poornima Rai, Paul Sidoti, Amy Gedal, James Luayon, Roma Ovase, Katy Tai, Quang Nguyen, Steven Shields, Kevin Anderson, Frank Moya, James Brandt, Michele Lim, Marilyn Sponzo, Mark Sherwood, Gregory Skuta,, Jason Jobson, Lisa Ogilbee, Adam Reynolds, Steven Sarkisian, Rohit Varma, Robert Feldman, Laura Baker, Nicholas Bell, Jo Lene Carranza, Brian Francis, Bruce Prum, Todd Perkins,, Paul Kaufman, Barbara Soderling, William Feuer, Luz Londono, Joyce Schiffman, Wei Shi, Philip Chen, Kuldev Singh, George Spaeth, Martha Wright, Gregory Skuta

Research output: Contribution to journalReview articlepeer-review

126 Scopus citations


PURPOSE OF REVIEW: The Tube Versus Trabeculectomy (TVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube-shunt surgery to trabeculectomy with mitomycin C (MMC) in eyes with previous cataract and/or failed glaucoma surgery. This article interprets results from the TVT Study and applies them to clinical practice. RECENT FINDINGS: Both tube-shunt surgery and trabeculectomy with MMC produced intraocular pressure (IOP) reduction to the low teens throughout the 5-year duration of the study. Tube-shunt surgery was associated with use of more glaucoma medications than trabeculectomy with MMC during the first 2 years of the study, but medical therapy equalized with longer follow-up. Trabeculectomy with MMC had higher rates of surgical failure and reoperation for glaucoma compared with tube-shunt surgery. Vision loss occurred at a similar rate with the two surgical procedures. Early complications were more frequent after trabeculectomy with MMC relative to tube-shunt surgery, but both procedures had similar rates of late postoperative complications and serious complications. SUMMARY: Tube-shunt surgery and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients who have undergone prior cataract and/or failed filtering surgery. Results of the TVT Study support the expanding use of tube shunts beyond refractory glaucomas.

Original languageEnglish
Pages (from-to)118-126
Number of pages9
JournalCurrent Opinion in Ophthalmology
Issue number2
StatePublished - 1 Mar 2012
Externally publishedYes


  • Glaucoma surgery
  • Trabeculectomy
  • Tube shunt


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