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Abstract #6529 Published in IGR 3-2
Trabeculectomy outcomes in advanced glaucoma in Nigeria
Anand N; Mielke C; Dawda VKEye 2001; 15: 274-278
BACKGROUND: Trabeculectomy remains the mainstay of therapy for advanced glaucoma in Nigeria, due to the unavailability and expense of topical therapy. Little is known of the medium- to long-term outcomes of trabeculectomy in West Africa. PURPOSE: To retrospectively assess outcomes, in terms of lowering of the intraocular pressure (IOP) and preserving the visual acuity, and the safety of trabeculectomy in patients with advanced glaucoma in Nigeria. METHODS: A retrospective case-note search was carried out from the operating theater records of a private hospital in Lagos, Nigeria, from 1989 to 1997. Patients undergoing primary trabeculectomy with a minimum follow-up of six months were included in the study. Visiting consultants and registrars from the UK performed the surgery. Descriptive statistics and life-table analysis were applied to the data. RESULTS: One hundred and forty-two eyes of 100 patients were included in the study. When the criteria for success were an IOP of less than 22 mmHg, 30% reduction from preoperative levels and a decrease in visual acuity of less than three Snellen chart lines, then by life-table analysis, success rates were 85%, 82%, and 71%, at the one-, two-, and five-year postoperative intervals, respectively. Success rates were lower if an IOP of less than 16 mmHg was taken as one of the criteria (65%, 61%, and 46%, a t the one-, two-, and five-year intervals, respectively). CONCLUSIONS: Trabeculectomy without antimetabolite use appears to be an effective way to lower the IOP of advanced glaucoma patients in Nigeria to less than 22 mmHg, but not to less than 16 mmHg. In experienced hands, the procedure is relatively safe, with few major complications.
Mr N. Anand, Department of Ophthalmology, Luton & Dunstable Hospital, Lewsey Road, Luton LU4 0DZ, UK. n-anand@ntlworld.com
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)