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Abstract #13921 Published in IGR 8-2
Trabeculectomy with mitomycin C in pseudophakic patients with open-angle glaucoma: outcomes and risk factors for failure
Fontana H; Nouri-Mahdavi K; Caprioli JAmerican Journal of Ophthalmology 2006; 141: 652-659
See also comment(s) by Paul Palmberg •
PURPOSE: To evaluate tonometric outcomes of trabeculectomy with mitomycin C in pseudophakic patients with open-angle glaucoma and associated risk factors for failure. DESIGN: Retrospective cohort study. METHODS: Seventy-three pseudophakic patients (89 eyes) with primary open-angle, normal-tension, exfoliative, or pigmentary glaucoma were recruited. Success rates were defined according to three criteria: (A) intraocular pressure (IOP) ≤ 18 mmHg and IOP reduction ≥ 20%; (B) IOP ≤ 15 mmHg and IOP reduction ≥ 25%; and (C) IOP ≤ 12 mmHg and IOP reduction ≥ 30%. IOP, visual acuity, complications, and additional interventions were documented after surgery. Cox's proportional hazard regression analysis was used to identify risk factors for failure. RESULTS: Mean IOP (± SD) decreased from a preoperative value of 18.8 ± 6.6 mmHg to 10.2 ± 5.1 mmHg at one year and to 10.0 ± 4.2 at two years (P < .001 for both). Average number of preoperative medications decreased from 3.0 ± 1.1 to 0.5 ± 1.0 at one year and to 0.5 ± 0.9 at two years (P < .001 for both). For criteria A, B, and C, success rates (± SE) were 87% ± 4%, 83% ± 5%, and 76% ± 5% at 1 year and 67% ± 4%, 58% ± 8%, and 50% ± 7 at two years. Laser suture lysis was performed in 30 eyes, and 11% of those required a second glaucoma procedure. CONCLUSION: Increasing age, use of a limbus-based conjunctival flap, and performance of laser suture lysis were factors that were associated with a smaller risk of failure. Present findings indicate that trabeculectomy with mitomycin C provides acceptable long-term success rates in pseudophakic patients, with a low incidence of complications.
Dr. H. Fontana, Glaucoma Division, Jules Stein Eye Institute, University of California, Los Angeles, CA, USA
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
