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PURPOSE: To evaluate the long-term outcome and complications of trabeculectomy with beta radiation. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Forty-three patients with confirmed primary open-angle glaucoma (POAG), who received trabeculectomy with adjunctive beta radiation at the Prince of Wales Hospital between June 1991 and November 1994. METHODS: Patients fulfilling the preceding criteria were followed up longitudinally. The visual acuity, intraocular pressure (IOP), bleb morphology, and complications were evaluated. MAIN OUTCOME MEASURES: Visual acuity, IOP, bleb morphology, complications. RESULTS: Forty-three eyes of 43 consecutive Chinese patients were recruited and successfully followed up for a minimum of seven years. The mean age ± 1 SD was 60.9 ± 13.0 years. There were 29 males and 14 females. The mean baseline IOP ± 1 SD was 28.3 ± 5.8 mmHg. The mean postoperative IOP ± 1 SD after the initial trabeculectomy was 11.9 ± 4.3 mmHg, and the mean number of preoperative IOP-lowering eye drops ± 1 SD was reduced from 2.8 ± 0.5 to 0.7 ± 1.0 at seven years' follow-up. The qualified success rate at seven years' follow-up, defined as IOP ≤ 21 mmHg with and without medication(s), was 88.4%. The complete success rate at seven years defined as IOP ≤ 21 mmHg without medication was 60.7%. Two eyes developed blebitis, and one of them progressed to corneal decompensation after the infection. One eye had hypotony, and one eye had a traumatic ruptured bleb. Twelve eyes (27.9%) developed significant cataract. No corneal ulceration or scleral necrosis was encountered. CONCLUSIONS: From this noncomparative study, trabeculectomy with a single dose of 1000 rad beta radiation used as an adjunctive measure for POAG in Chinese eyes had achieved a qualified success rate of 88.4% at seven years.
Dr. J.S. Lai, Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong, China
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)