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Abstract #18281 Published in IGR 3-3
Long-term follow-up of initial 5-fluorouracil trabeculectomy in primary open-angle glaucoma in Japanese patients
Uchida S; Suzuki Y; Araie M; Shigeeda T; Hara T; Shirato SJournal of Glaucoma 2001; 10: 458-465
PURPOSE: To evaluate the long-term efficacy and safety of initial trabeculectomy with subconjunctival 5-fluorouracil in Japanese patients with primary open-angle glaucoma. SUBJECTS AND METHODS: Clinical records of 117 eyes from 117 patients with records of up to 14 years were retrospectively analyzed using the appropriate statistical methods. RESULTS: The mean follow-up period was 6.2 ± 3.6 years. Criteria for successful intraocular pressure (IOP) control and success probability by Kaplan-Meier method at 12 years were IOP < 21 mmHg without medication plus a 30% or more reduction in IOP, 50.4 ± 5.2% (SE) 38.2 ± 5.3%; and IOP < 16 mmHg without medication plus a 30% or more reduction in IOP, 45.9 ± 5.1% (36.5 ± 5.2%). Cox multiple regression analysis showed that younger age was associated with a higher success probability (p < 0.01). Eyes with lower postoperative IOP tended to show a more positive value of the MD slope (p = 0.0669), whereas 7% of successfully treated eyes showed a negative postoperative MD slope (p < 0.1). The probabilities for developing bleb leaks and bleb-related infections in eyes with a functioning bleb were 28.9 ± 12.5% and 13.0 ± 10.4% at 12 years. CONCLUSIONS: Trabeculectomy with 5-fluorouracil as an initial surgery in Japanese patients with primary open-angle glaucoma was effective for long-term control of glaucoma. However, the probability of late-onset bleb-related complications was not low in eyes with a functioning bleb, stressing the importance of constant care regarding bleb status.
Dr S. Uchida, Department of Ophthalmology, Tokyo University School of Medicine, Tokyo, Japan
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
