advertisement
Abstract #50397 Published in IGR 14-2
ReGAE 9: baseline factors for success following augmented trabeculectomy with mitomycin C in African-Caribbean patients
Agrawal P; Shah P; Hu V; Khaw PT; Holder R; Sii FClinical and Experimental Ophthalmology 2013; 41: 36-42
BACKGROUND: To identify the baseline factors influencing success following trabeculectomy with mitomycin C (MMC) in a case series of African-Caribbean patients. DESIGN: A prospective, observational and non-comparative case series. PARTICIPANTS: Forty-seven consecutive African-Caribbean patients (47 eyes) with glaucoma. METHODS: Association between trabeculectomy survival and study factors was examined using Fisher's exact test and the 2-sample t test at 12, 24 and 36 months following trabeculectomy. Logistic regression was used to establish the combination of factors best predicting survival. MAIN OUTCOME MEASURES: Surgical success was based upon intraocular pressure (IOP) reduction to ≤ 21 mmHg, ≤ 18 mmHg and ≤ 15 mmHg without glaucoma medication (criterion 1); or IOP reduction to ≤ 21 mmHg, ≤ 18 mmHg and ≤ 15 mmHg with or without glaucoma medication (criterion 2). RESULTS: Trabeculectomy survival at 36 months was significantly decreased with the use of preoperative acetazolamide, pseudophakic status and higher preoperative IOPs (p < 0.05). In pseudophakic eyes there was a lower rate of success for criterion 2 when aiming for an IOP ≤ 15 mmHg at 2 years post-trabeculectomy, the odds ratio being 12. CONCLUSIONS: Three major independent risk factors were identified which influenced trabeculectomy failure at 3 years in AFCs; the preoperative use of acetazolamide, pseudophakic status and higher preoperative IOP. The presence of these risk factors may guide the clinician to use a more aggressive antiproliferative and postoperative management regime to enhance survival rates in this high-risk population. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK Centre for Health and Social Care Improvement, School of Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK National Institute for Health Research Biomedical Research Centre, UCL Partners/ Moorfields Eye Hospital NHS Foundation Trust, London, UK UCL Institute of Ophthalmology, London, UK Department of Primary Clinical Care Sciences, University of Birmingham, Birmingham, UK.
Full articleClassification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
