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Abstract #106597 Published in IGR 23-3
Efficacy and safety of ab interno trabeculectomy revision with 5-fluorouracil in advanced glaucoma due to subconjunctival fibrosis
Ruparelia S; Rafuse PE; Eadie BDCanadian Journal of Ophthalmology 2022; 0:
OBJECTIVE: To describe the outcomes of patients who underwent a single ab interno trabeculectomy revision augmented with 5-fluorouracil. DESIGN: Retrospective cohort study. PARTICIPANTS: All patients who had undergone ab interno trabeculectomy revision at a single tertiary care centre during the 5-year study period. All patients had advanced glaucomatous optic neuropathy, and all treated ages and glaucoma subtypes were included. METHODS: Outcome measures included surgical success, number of topical intraocular pressure (IOP)-lowering drops, best-corrected visual acuity, visual field mean deviation, and postoperative complications. Success at 12 months was defined using 2 criteria: criterion A (IOP <15 mm Hg and >20% reduction) and criterion B (IOP <12 mm Hg and >20% reduction). Each success criterion was subdivided into patients who achieved success without topical IOP-lowering drops (complete success) or with topical therapy (qualified success). RESULTS: This study included 46 eyes of 46 patients. Of these, 34 patients were followed for 12 months or more to assess surgical success. Success defined by criterion A was achieved by 68% of these 34 patients (53% complete, 15% qualified). Success defined by criterion B was achieved by 47% of these patients (38% complete, 9% qualified). Early hypotony was noted in 68% of eyes but was not associated with negative visual acuity or visual field outcomes. CONCLUSIONS: An IOP of <12 mm Hg and a >20% IOP reduction were achieved by 47% of patients overall (with or without topical therapy) at 12 months of follow-up. Transient early postoperative hypotony should be expected following ab interno revision trabeculectomy.
Faculty of Medicine, Dalhousie University, Halifax, NS.; Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS.. Electronic address: sunil.ruparelia@dal.ca.
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