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Abstract #66295 Published in IGR 17-3
Long-term Outcomes of Mitomycin-C Trabeculectomy in Exfoliative Glaucoma Versus Primary Open-Angle Glaucoma
Lim SH; Cha SCJournal of Glaucoma 2017; 26: 303-310
PURPOSE: To compare long-term surgical outcomes in exfoliative glaucoma (XFG) versus primary open-angle glaucoma (POAG) after primary trabeculectomy with mitomycin-C. METHODS: This retrospective, case-control study included 32 eyes of XFG and 64 eyes of POAG matched by propensity score analysis. Surgical success was defined according to 3 different criteria: (1) intraocular pressure (IOP)<18 mm Hg and IOP reduction ≥20% without medication; (2) IOP<15 mm Hg and IOP reduction ≥25% without medication; and (3) IOP<18 mm Hg and IOP reduction ≥20% with or without medication. Cumulative probabilities of success were compared using Kaplan-Meier survival analysis, and risk factors of surgical failure were analyzed. RESULTS: Cumulative success rates were 84.4% at 1 year and 19.9% at 5 years for XFG, and 82.3% and 64.7%, respectively, for POAG by criterion A. Complete success rates were significantly lower for XFG than for POAG by criteria A and B. However, qualified success, as determined by criterion C, did not show a statistically significant difference. Postoperative hyphema was more frequent for XFG. The risk factors associated with surgical failure were a young age (<60 y; hazard ratio=2.58, P=0.047, criterion A) and exfoliation syndrome (hazard ratio=3.01, 2.96, P=0.006, 0.005, criteria A and B). CONCLUSIONS: Although trabeculectomy for XFG had success rates similar to POAG at 1 year, XFG showed poorer long-term IOP control from 2 years postoperatively. This study indicates that it is more difficult to achieve long-term low target IOP control in eyes with XFG than in eyes with POAG after trabeculectomy with mitomycin-C.
*Department of Ophthalmology, Daegu Veterans Health Service Medical Center †Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Republic of Korea.
Full articleClassification:
9.4.4.1 Exfoliation syndrome (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
