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Abstract #6232 Published in IGR 2-2
Trabeculectomy without antimetabolite in black African primary open angle glaucoma
Lam A; Seck C-M; Borzeix A; Faye M; Pintart DJournal Français d'Ophtalmologie 2000; 23: 563-568
PURPOSE: To assess simple trabeculectomy in black Africans with open-angle glaucoma. METHODS: The authors retrospectively studied 80 eyes of 62 patients with primary open-angle glaucoma operated on by Cairn's trabeculectomy without adjunction of antimetabolites. Thirty-seven eyes had a limbal-based conjonctival flap and the other 43 had a fornix-based conjonctival flap. Failures and success were assessed with Kaplan-Meier method. RESULTS: Patients were all seen at least 12 months after surgery. The mean follow-up was 24 months. At the mid-term survey, the authors found complications to be frequent. Pathological blebs occurred in 22.5% (18 cases). The survival probability grew shorter with time. Only 44% of patients were reviewed at 36 months, and 29% at 48 months. The success rate (IOP less than 21 mmHg of all glaucoma medications) varied according to the conjunctival flap. At 12, 24, and 36 months, this was 97%, 70% and 54%, respectively, with the limbal-based flap, and 46%, 18% and 18%, respectively, with the fornix-base flap. The overall rate of tonometric failures was 33.75%. Failures were seen more often with the fornix-based flap (85%). Generally, they set in within one year, This was so in 91% of absolute failures and in 87% of relative failures. The failures rate seems to increase with topical polytherapy given more than 12 months before operation. CONCLUSIONS: Trabeculectomy with a limbal-based conjunctival flap was successful in black Africans at the mid-term folow-up. However, the difficulties regarding follow-up in Africa make it too delicate an assessment to be objective for the long-term results of trabeculectomy.
Dr. A. Lam, Service d'Ophtalmologie, Hôpital Principal de Dakar, BP 3006, Dakar, Senegal
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
