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Abstract #13192 Published in IGR 7-3
Audit of trabeculectomy at a tertiary referral hospital in East Africa
Kabiru J; Bowman R; Wood M; Mafwiri MJournal of Glaucoma 2005; 14: 432-434
AIM: To audit medium-term results of trabeculectomy at a tertiary referral unit in east Africa. METHODS: A retrospective review of the files of all patients who underwent trabeculectomy surgery at our hospital during the year 2001. RESULTS: One hundred fifty-seven patients were included. Mean age was 61 years (SD = 12). Thirty-one patients (20%) were women; 120 of 145 (83%) eyes had cup/disc ratios of 0.8 or greater preoperatively. Intraoperative 5-fluorouracil (5FU) was used in 57 cases (36%). Mean follow-up was 8 months (0-28, SD = 7). Mean intraocular pressures (IOP) was 25 mmHg (6-70, SD = 10) preoperatively, 11 mmHg (0-32, SD = 5) at 2 weeks postoperatively, and 13 mmHg (0-42, SD = 6) at latest follow-up. One hundred fifteen patients (73%) had intraocular pressure of 15 mmHg or less at latest follow-up and 141 (90%) had intraocular pressure of 21 mmHg or less. Twenty (13%) had restarted antiglaucoma medication during the follow-up period. Thirty-seven of 148 (25%) lost 2 lines of Snellen acuity or equivalent between preoperative measurement and latest follow-up. Early postoperative complications (usually leaking bleb or shallow anterior chamber with hypotony) occurred in 18 patients (12%) and this was associated with postoperative loss of 2 or more lines of Snellen acuity (OR = 1.11 95% CI 1.02-1.22, P = 0.02). Patients having had 5FU had lower (t = 3.11, P = 0.02) mean intraocular pressure at 2-month follow-up (12 mmHg, SD = 5) than those who did not receive it (16 mmHg, SD = 6) but there was no significant difference at later follow-ups. Men (mean 14 mmHg, SD = 6) had higher (t = 2.71, P = 0.01) intraocular pressures at latest follow-up than women (mean 11 mmHg, SD = 3). CONCLUSIONS: The results of surgery compare well with other reported series. 5FU did not demonstrate significant benefit in terms of intraocular pressure lowering beyond 2 months postoperatively. Early postoperative hypotony should be avoided. The gender difference in intraocular pressure results has not previously been reported and deserves further investigation.
Dr. J. Kabiru, Comprehensive Community Based Rehabilitation for Tanzania Disability Hospital, Dar es Salaam, Tanzania
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
