Influence of preoperative glaucoma medication on long-term outcomes of trabeculectomy.

Sci Rep

Department of Ophthalmology, Yeungnam University College of Medicine, Yeungnam University Hospital, Daegu, Korea.

Published: November 2024

AI Article Synopsis

  • - This study reviewed the long-term effects of preoperative glaucoma medication containing preservatives on the success of trabeculectomy in patients with primary open-angle glaucoma, following 309 eyes for over 10 years.
  • - The findings showed that a higher cumulative exposure to these medications (measured by the Glaucoma Medication Intensity Index or GMII) correlated with reduced surgical success rates and poorer intraocular pressure control over time.
  • - Key risk factors for trabeculectomy failure were identified as advanced age, higher GMII levels, and subsequent cataract surgery, emphasizing the importance of managing medication use before surgery for better outcomes.

Article Abstract

This retrospective study evaluated the association between preoperative topical glaucoma medication containing preservatives and long-term trabeculectomy outcomes in 309 eyes from 201 patients with primary open-angle glaucoma, followed for over 10 years. The Glaucoma Medication Intensity Index (GMII) was calculated to quantify the cumulative preoperative exposure to these medications. Kaplan-Meier analysis revealed cumulative success rates of 89.3%, 59.2%, and 46% at 1, 10, and 20 years postoperatively. At 20 years, the success group had a significantly lower GMII (3.28 vs. 8.74, p = 0.004). A GMII threshold of ≥ 4.35 was associated with poorer long-term intraocular pressure (IOP) control and shorter surgical success duration. Cox regression analysis identified advanced age at surgery, higher GMII, and subsequent cataract surgery as significant risk factors for trabeculectomy failure. These findings underscore the adverse impact of prolonged preoperative use of glaucoma medications on long-term surgical outcomes, highlighting GMII as a valuable predictor for guiding preoperative management strategies.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569146PMC
http://dx.doi.org/10.1038/s41598-024-79637-zDOI Listing

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