advertisement
Abstract #10194 Published in IGR 6-1
Factors associated with success in first-time trabeculectomy for patients at low risk of failure with chronic open-angle glaucoma
Edmunds B; Bunce CV; Thompson JR; Salmon JF; Wormald RPOphthalmology 2004; 111: 97-103
PURPOSE: To examine the relationships between study factors and trabeculectomy outcome in a representative sample of UK ophthalmology surgeons and patients. DESIGN: Cross-sectional observational study by questionnaire. PARTICIPANTS: All ophthalmic surgeons performing trabeculectomy in the National Health Service were invited to select their four most recent consecutive trabeculectomy cases satisfying study eligibility criteria before June 1996. Three hundred and eighty-two surgeons supplied baseline data for 1450 patients and one-year follow-up data for 1240 (85.3%) patients. All patients had undergone first-time trabeculectomy for chronic open-angle glaucoma. METHODS: Data were collected by self-administered questionnaires at baseline and six and 12 months postoperatively. Univariate analysis of the relationships between study factors and success was performed by chi-square test (categorical variables) and Student's t or Mann-Whitney U tests (continuous variables). Multiple logistic regression modeling of explanatory variables significant at a p value of ≤ 0.1 was then performed. MAIN OUTCOME MEASURE: Trabeculectomy success, defined as a final intraocular pressure (IOP) less than two thirds of the preoperative IOP, excluding patients on antiglaucoma medications. RESULTS: After multiple logistic regression modeling, diabetes (odds ratio (OR) = 0.485, 95% confidence interval (CI) = 0.271-0.868, p = 0.015), superior rectus traction suture (OR = 0.580, 95% CI = 0.348-0.959, p = 0.034), subconjunctival anesthetic (OR = 0.172, 95% CI = 0.065-0.459, p < 0.0001), and nonspecialist surgeons (OR = 0.539, 95% CI = 0.335-0.865, p = 0.010) remained significantly associated with poorer outcome. CONCLUSIONS: In this nationally representative sample of glaucoma patients undergoing first-time trabeculectomy, the authors identified important associations between diabetes, superior rectus traction suture, subconjunctival anesthetic, nonspecialist surgeons, and diminished trabeculectomy success. These associations merit further examination.
Dr. B. Edmund,s Royal College of Ophthalmologists, London, UK. bethedmunds@ukonline.co.uk
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
