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Abstract #6535 Published in IGR 3-2
Mini-trabeculectomy as initial surgery for medically uncontrolled glaucoma
Ophir AAmerican Journal of Ophthalmology 2001; 132: 229-234
PURPOSE: To report on the surgical outcome after at least 12 months of follow-up of mini-trabeculectomy (without radial incisions) as initial surgery. METHODS: In a prospective, institutional study, mini-trabeculectomy was performed as the initial surgical therapy on 41 eyes with medically uncontrolled glaucoma of 41 consecutive patients aged 40 years or older. Mini-trabeculectomy consists of a 3-mm fornix-based conjunctival flap, sclerostomy at 1 mm from the limbus, and a sclerocorneal tunnel without radial incisions. Of the 41 eyes, four did not complete 12 months of follow-up. Of the remaining 37 eyes, one underwent cataract extraction five months postoperatively and was evaluated for surgical complications only. Thirty-six patients with a mean age of 70.3 ± 7.4 SD years (range, 54-87) completed 12 months or more of follow-up. RESULTS: In the 36 eyes, mean preoperative intraocular pressure (IOP) was 30.2 ± 9.3 mmHg (range, 19-54) with 3.0 ± 1.2 hypotensive medications (range, 1-4). After a mean postoperative follow-up of 25.0 ± 9.2 months (range, 12-43), IOP was at or below the planned target IOP in 35 eyes (97.2%, p < 0.0001) and mean IOP was 16.0 ± 2.8 mmHg (range, 11-21) with 0.8 ± 1.- medications (range, 0-3). Postoperative complications in the 37 eyes included early postoperative aqueous leakage with moderately shallow or deep anterior chambers in two eyes (5.4%), and rapid cataract progression in one eye (2.7%). The four eyes that were excluded from the study had IOPs of 10-16 mmHg with no or one hypotensive medication, three to nine months after surgery, respectively. CONCLUSIONS: Mini-trabeculectomy, which may offer clinical and technical advantages over standard trabeculectomy, was generally efficacious and relatively safe, based on outcome observed at a mean of 25 months' follow-up. A controlled study is required to confirm these observations.
Dr A. Ophir, Department of Ophthalmology, Hillel-Yaffe Medical Center, Hadera, Israel. Ophthalmology@hillel-yaffe.health.gov.il
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)