advertisement
Abstract #3706 Published in IGR 4-2
Analysis of intraoperative and early postoperative complications and safety in non-penetrating trabecular surgery
Wang N; Wu H; Ye TChinese Journal of Ophthalmology 2002; 38: 329-334
OBJECTIVE: To evaluate the safety, effectiveness and complications of non-penetrating trabecular surgery (NPTS). METHODS: A total of 168 patients (258 eyes) with primary open-angle glaucoma were divided into two groups randomly, and they were matched according to the age, sex and severity of disease. NPTS with reticulated hyaluronic acid implant was performed in one group, and traditional trabeculectomy in the other. Preoperative mean intraocular pressure (IOP) in the NPTS group and trabeculectomy group was 31.85 ± 4.83 and 32.59 ± 4.62 mmHg (1 mmHg = 0.133 kPa), respectively. The postoperative IOP and complications in these two groups were compared. RESULTS: (1) IOP: The mean IOP on postoperative days 7, and 14, and months 1, 3, and 6 was 6.67 ± 2.43, 11.42 ± 2.89, 12.59 ± 2.24, 15.45 ± 1.82, and 17.99 ± 1.80 mmHg, respectively, in the NPTS group, while that in the trabeculectomy group for the same time series was 4.87 ± 1.65, 10.48 ± 2.38, 12.01 ± 2.83, 15.01 ± 2.66, and 17.48 ± 2.97 mmHg, respectively. Statistically significant differences between these two groups were found on postoperative days 7 and 14 (t = 7.03, 2.89; p < 0.0001, p = 0.004). However, no significant difference was noted for preoperative and other postoperative IOP during the follow-up (t = 1.28, 1.78, 1.55, 1.60; p = 0.202, 0.077, 0.124, 0.112). (2) Visual acuity: There were no statistical differences in visual acuity between the two groups (κ2 = 0.135, 0.151, 0.024, 0.076; p = 0.935, 0.927, 0.988, 0.963). (3) Complications: One- and two-degree shallow anterior chambers were encountered in 57 eyes in the NPTS group, while in 70 eyes in the trabeculectomy group. Twelve eyes with three-degree shallow anterior chambers were found exclusively in the trabeculectomy group. Ciliary body and choroidal detachment were found in 66 and 70 eyes, respectively, in the NPTS and trabeculectomy groups. Hypotony was encountered in five eyes exclusively in the trabeculectomy group. Complications were found to be statistically different in the two groups (κ2 = 9.95, 15.27, 4.60, 6.19; P < 0.05). Hyphema was found in two and six eyes, respectively, in the NPTS and trabeculectomy groups. Light anterior uveitis was found in five and nine eyes, respectively, in the NPTS and trabeculectomy groups. Vitreous extrusion was experienced in one eye in the trabeculectomy group. Some complications (16.2%) related to operative skill were also encountered in the NPTS group. CONCLUSIONS: Over-filtration and surgical injury related complications are significantly reduced in the NPTS group compared to those in the trabeculectomy group. NPTS is safer than traditional trabeculectomy. Mastering surgical skills is required for reducing complications of NPTS. LA: Chinese
Dr. N. Wang, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China. wningli@21cn.com
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
