Purpose: To determine rates of success and complications of trabeculectomy surgery.
Design: Case series.
Participants: Consecutive patients undergoing trabeculectomy by 2 surgeons between May 2000 and October 2008.
Intervention: By using the Wilmer Institute's billing database, we identified all patients at least 12 years of age coded as having undergone trabeculectomy between May 2000 and October 2008 by 1 of 2 glaucoma surgeons and whose surgery was not combined with another operation. From the chart, we abstracted demographic information on the patients and clinical characteristics of the eyes. The Kaplan-Meier product-limit method and Cox proportional hazard models were used to look at success rates and characteristics associated with inadequate intraocular pressure (IOP) reduction. Complications were tabulated.
Main Outcome Measures: (1) Success rate of trabeculectomy, as determined by the achievement of each of 4 different IOP goals, with or without IOP-lowering medications; and (2) incidence of surgical complications.
Results: During the study period, 797 eyes of 634 persons underwent trabeculectomy without concurrent surgery. The success rates 4 years after surgery, with or without the use of IOP-lowering eye drops, were 70%, 72%, 60%, and 44%, for achievement of target IOP, ≤18 mmHg and ≥20% IOP reduction, ≤15 mmHg and ≥25% reduction, and ≤12 mmHg and ≥30% reduction, respectively. Increased chance of success was associated with European-derived race; use of mitomycin C (MMC); higher concentrations of MMC, when used; and higher preoperative IOP. Age and previous intraocular surgery were not associated with surgical success. Complications included worsening lens opacity in 242 of 443 phakic eyes (55%), loss of ≥3 lines of acuity (Snellen) in 161 eyes (21%), surgery for bleb-related problems in 70 eyes (8.8%), and infection occurring >6 weeks after surgery in 27 eyes (3.4%). A total of 101 eyes of 94 patients had at least 1 subsequent operation for inadequate IOP control.
Conclusions: Trabeculectomy surgery performed by 2 experienced glaucoma specialists achieved target IOP at 4 years in 70% of those operated and was associated with progressive cataract and small risks of bleb-related complications. These results are comparable to those reported in smaller series.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ophtha.2011.09.049 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparison of efficacy and safety between gonioscopy-assisted transluminal trabeculotomy and trabeculectomy for primary open-angle glaucoma treatment: a retrospective cohort study.
BMC Ophthalmol
December 2024
Department of Ophthalmology, Qilu Hospital of Shandong University, Wenhua Xi Road 107, Jinan, 250012, Shandong, PR China.
Background: Trabeculectomy (TRAB) traditionally has been the gold-standard surgical treatment for primary open-angle glaucoma (POAG), while gonioscopy-assisted transluminal trabeculotomy (GATT) is an emerging minimally invasive surgery used for the treatment of various open-angle glaucoma (OAG) types. In this study, we aimed to compare the efficacy and safety between GATT and TRAB for the treatment of POAG.
Methods: This cohort study included eyes with POAG that underwent a single GATT (30 eyes) or TRAB (34 eyes).
Purpose: The Xen gel stent is a surgical glaucoma device which creates a subconjunctival filtering bleb, which has demonstrated good intraocular pressure (IOP) lowering and safety. Nonetheless, bleb-related problems have been reported. We present a case series of ab externo Xen procedures augmented with a deep intra-scleral lake, aiming to improve both IOP-lowering and post-operative management.
View Article and Find Full Text PDFComparing the safety and efficacy of Preserflo Microshunt implantation and trabeculectomy for glaucoma: A systematic review and meta-analysis.
Acta Ophthalmol
June 2024
Discipline of Surgery, School of Medicine, Clinical Science Institute, National University of Ireland, Galway, Ireland.
To compare the safety and efficacy of the Preserflo Microshunt with trabeculectomy in the treatment of patients with glaucoma. A systematic review and meta-analysis was conducted. The primary outcome measures recorded as a measure of efficacy of the interventions were intra-ocular pressure (IOP) at final follow-up and IOP reduction (IOPR).
View Article and Find Full Text PDFSurgical management of glaucoma in microspherophakia using quadruple procedure.
Indian J Ophthalmol
November 2023
Department of Glaucoma, Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Background: Microspherophakia is a rare developmental lens anomaly with increased anteroposterior and reduced equatorial diameter. It presents with refractive myopia, shallow anterior chamber, and angle closure glaucoma. It is associated with subluxated or dislocated lens, progressive myopia, defective accommodation, and glaucoma.
View Article and Find Full Text PDF[Medium-term efficacy and safety analysis of Ex-PRESS shunt implantation for the treatment of secondary glaucoma in Sturge-Weber syndrome].
Zhonghua Yan Ke Za Zhi
September 2023
Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China.
To evaluate the medium-term efficacy and safety of Ex-PRESS shunt implantation in the treatment of secondary glaucoma associated with Sturge-Weber Syndrome (SWS). This was a retrospective case series study. Medical records of patients diagnosed with secondary glaucoma due to SWS who underwent Ex-PRESS shunt implantation at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, between January 2013 and February 2020 were collected.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!