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Abstract #8042 Published in IGR 4-3
Analysis of intra-operative and early post-operative complications and safety in non-penetrating trabecular surgery
Wang N; Wu H; Ye T; Chen X; Zeng M; Fan ZChinese 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 randomly into two groups, matched according to age, sex, and severity of disease. NPTS with reticulated hyaluronic acid implant was taken in one group, and traditional trabeculectomy was taken 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 (1a(c) mmHg = 0.133 kPa), respectively. Postoperative IOP and complications in the two groups were compared. RESULTS: IOP: Mean IOP on the seventh and 14th postoperative days, and first, third, and 6th postoperative months 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 a(c) 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 the two groups were found on the seventh and 14th postoperative days (t = 7.03, 2.89; p < 0.0001, p = 0.004). However, no significant difference was noted for preoperative and other postoperative IOPs during the follow-up (t = 1.28, 1.78, 1.55, 1.60; p = 0.202, 0.077, 0.124, 0.112). 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). Complications: I and II degree shallow anterior chambers were encountered in 57 eyes in the NPTS group, and in 70 in the trabeculectomy group. Twelve eyes with III degree shallow anterior chambers were only found in the trabeculectomy group. Ciliary body or choroidal detachment was found in 66 and 70 eyes, respectively, in the NPTS and trabeculectomy groups. Hypotony was encountered in five eyes in the trabeculectomy group. Complications were found to be statistically different in 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 seen in one eye in the trabeculectomy group. Some complications (16.2%) related to operative skill were also experienced in the NPTS group. CONCLUSIONS: Over-filtration and surgical-injury-related complications were significantly reduced in the NPTS group compared to those in the trabeculectomy group. NPTS is safer than traditional trabeculectomy. The mastering of surgical skills is required for reducing complications of NPTS. LA: Chinese
N. Wang, MD, 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)
