Adjunctive sub-tenon triamcinolone with Susanna glaucoma drainage device: a randomized clinical trial
- 1Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
- 2Fundação Altino Ventura (FAV), Recife, Pernambuco, Brazil
Abstract
Purpose: To evaluate the efficacy and safety of Adjunct Triamcinolone (TA) with the Susanna drainage device for refractory primary open-angle glaucoma, to our knowledge, the first such evaluation with a non-valved glaucoma drainage device.
Methods: This prospective, multicenter, randomized, double-blind (patient and outcome assessor) trial included 39 eyes with refractory primary open-angle glaucoma, divided into a control (n = 20) and a triamcinolone group (n = 19). Primary outcome was mean Intraocular Pressure (IOP) at six months. Secondary outcomes included success rates and postoperative complications.
Results: Baseline characteristics and mean preoperative IOP were similar (24.45±8.03 mmHg control vs. 24.95±6.80 mmHg TA, p = 0.83). At six months, both groups showed similar mean IOP reduction (14.05±3.99 mmHg control vs. 14.33±4.70 mmHg TA, p > 0.99), with percentage reductions of 42.53% and 42.56%, respectively. Hypotensive eyedrop use also decreased similarly (1.57 control vs. 1.16 TA, p = 0.95). Qualified success (IOP 5‒21 mmHg) was 90% (control) and 89.47% (TA) (p > 0.05). However, the triamcinolone group had a significantly higher incidence of late-onset hypotony (52.6%vs. 0%, p < 0.001). Clinically significant hypotony requiring surgical re-intervention occurred in 36.8% of the TA group versus 0% in the control group (p = 0.003).
Conclusion: In patients undergoing Susanna GDD implantation, adjunctive sub-Tenon triamcinolone provided no additional IOP-lowering benefit but was associated with a significantly increased risk of serious hypotony-related complications. Our findings do not support the use of sub-Tenon triamcinolone (20 mg) as an adjunct to non-valved GDDs in this setting.
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BibTeX
@article{takatsu2026adjunctive,
title = {{Adjunctive sub-tenon triamcinolone with Susanna glaucoma drainage device: a randomized clinical trial}},
author = {Marcus Vinicius Takatsu and Karin Chiaradia Takatsu and Kaio Santos Soares and Kayo Pinheiro Esposito and Leonardo Eleuterio Ariello and Renato Antunes Schiave Germano and Marcio Henrique Mendes and Aline Domingos Pinto Ruppert and Marcelo Hatanaka},
journal = {Clinics},
year = {2026},
month = oct,
doi = {10.1016/j.clinsp.2026.101221},
url = {https://doi.org/10.1016/j.clinsp.2026.101221},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Adjunctive sub-tenon triamcinolone with Susanna glaucoma drainage device: a randomized clinical trial
AU - Marcus Vinicius Takatsu
AU - Karin Chiaradia Takatsu
AU - Kaio Santos Soares
AU - Kayo Pinheiro Esposito
AU - Leonardo Eleuterio Ariello
AU - Renato Antunes Schiave Germano
AU - Marcio Henrique Mendes
AU - Aline Domingos Pinto Ruppert
AU - Marcelo Hatanaka
PY - 2026
DA - 2026/10/30
JO - Clinics
DO - 10.1016/j.clinsp.2026.101221
UR - https://doi.org/10.1016/j.clinsp.2026.101221
AB - Purpose: To evaluate the efficacy and safety of Adjunct Triamcinolone (TA) with the Susanna drainage device for refractory primary open-angle glaucoma, to our knowledge, the first such evaluation with a non-valved glaucoma drainage device. Methods: This prospective, multicenter, randomized, double-blind (patient and outcome assessor) trial included 39 eyes with refractory primary open-angle glaucoma, divided into a control (n = 20) and a triamcinolone group (n = 19). Primary outcome was mean Intraocular Pressure (IOP) at six months. Secondary outcomes included success rates and postoperative complications. Results: Baseline characteristics and mean preoperative IOP were similar (24.45±8.03 mmHg control vs. 24.95±6.80 mmHg TA, p = 0.83). At six months, both groups showed similar mean IOP reduction (14.05±3.99 mmHg control vs. 14.33±4.70 mmHg TA, p > 0.99), with percentage reductions of 42.53% and 42.56%, respectively. Hypotensive eyedrop use also decreased similarly (1.57 control vs. 1.16 TA, p = 0.95). Qualified success (IOP 5‒21 mmHg) was 90% (control) and 89.47% (TA) (p > 0.05). However, the triamcinolone group had a significantly higher incidence of late-onset hypotony (52.6%vs. 0%, p < 0.001). Clinically significant hypotony requiring surgical re-intervention occurred in 36.8% of the TA group versus 0% in the control group (p = 0.003). Conclusion: In patients undergoing Susanna GDD implantation, adjunctive sub-Tenon triamcinolone provided no additional IOP-lowering benefit but was associated with a significantly increased risk of serious hypotony-related complications. Our findings do not support the use of sub-Tenon triamcinolone (20 mg) as an adjunct to non-valved GDDs in this setting.
SN - 1807-5932
SN - 1980-5322
ER -