A recent retrospective study published in BMJ Open Ophthalmology compared the risk of postoperative cystoid macular edema (CME) following trabeculectomy versus tube shunt implantation in 2,928 non-diabetic patients with glaucoma. CME occurred significantly less frequently in patients undergoing trabeculectomy than in those receiving tube shunt implantation at both 1 month (1.15% vs 1.85%) and 3 months (2.19% vs 4.20%). Relative to tube shunt surgery, trabeculectomy was associated with a 35% lower risk of CME at 1 month (aHR 0.64) and a 45% lower risk at 3 months (aHR 0.55).
Additionally, male sex (aHR 1.32), macular puckering (aHR 2.75), and the use of topical alpha agonists (aHR 1.61) were independently linked to a higher risk of CME. These findings suggest that trabeculectomy may offer a significantly lower risk of postoperative CME compared with tube shunt surgery in non-diabetic…
