Trabeculectomy Outcomes After Glaucoma Drainage Device Surgery.
Alizadeh Reza, Akil Handan, Tan James, Law Simon K, Caprioli Joseph
AI Summary
Trabeculectomy effectively lowers intraocular pressure in patients with uncontrolled glaucoma after drainage device surgery, offering a viable treatment option despite potential complications like hypotony.
Abstract
Purpose
To evaluate outcomes of trabeculectomy with adjunctive mitomycin C in patients with uncontrolled intraocular pressure (IOP) after glaucoma drainage device implantation.
Materials and methods
Consecutive patients who had undergone a trabeculectomy after GDD were reviewed. The primary outcome was surgical success with stratified IOP targets based on the following criteria: (A) IOP<18 mm Hg and IOP reduction of 20%; (B) IOP<15 mm Hg and IOP reduction of 25%; (C) IOP<12 mm Hg and IOP reduction of 30%. Secondary outcomes were number of glaucoma medications, complications, and need for additional glaucoma surgery.
Results
Twenty eyes (19 patients) were included for analysis. Median follow-up and age were 3.7 years (range, 1.1 to 10.2 y) and 64.2 years (range, 25.2 to 85.6 y), respectively. Mean IOP (±SD) has dropped from 19.3±4.2 mm Hg preoperatively to 9.8±2.2 mm Hg at 1 year, 8.8±3.2 mm Hg at 3 years and 8.4±1.5 mm Hg at 5 years (P<0.001 for all). Hypotony maculopathy was the only serious complication (2/19 patients; 10%) that needed surgical revision. The cumulative success rate (±SD) for criterion A and B were 73.2% (±10.0%) and 68.2% (±9.5%), respectively, between the first and fifth year of follow-up, for criterion C it was 49.1% (±10.8%) at the first year and 32.7% (±12%) between the second and fifth year of follow-up.
Conclusions
Trabeculectomy is a viable surgical option to treat IOP that is uncontrolled after GDD implantation.
MeSH Terms
Shields Classification
Key Concepts6
Trabeculectomy with adjunctive mitomycin C is a viable surgical option to treat uncontrolled intraocular pressure (IOP) after glaucoma drainage device (GDD) implantation.
The mean intraocular pressure (IOP) in patients undergoing trabeculectomy after glaucoma drainage device implantation dropped from 19.3±4.2 mm Hg preoperatively to 9.8±2.2 mm Hg at 1 year, 8.8±3.2 mm Hg at 3 years, and 8.4±1.5 mm Hg at 5 years (P<0.001 for all).
The cumulative success rate for trabeculectomy with adjunctive mitomycin C in patients with uncontrolled intraocular pressure after glaucoma drainage device implantation, based on criterion A (IOP<18 mm Hg and IOP reduction of 20%), was 73.2% (±10.0%) between the first and fifth year of follow-up.
The cumulative success rate for trabeculectomy with adjunctive mitomycin C in patients with uncontrolled intraocular pressure after glaucoma drainage device implantation, based on criterion B (IOP<15 mm Hg and IOP reduction of 25%), was 68.2% (±9.5%) between the first and fifth year of follow-up.
The cumulative success rate for trabeculectomy with adjunctive mitomycin C in patients with uncontrolled intraocular pressure after glaucoma drainage device implantation, based on criterion C (IOP<12 mm Hg and IOP reduction of 30%), was 49.1% (±10.8%) at the first year and 32.7% (±12%) between the second and fifth year of follow-up.
Hypotony maculopathy was the only serious complication, occurring in 2 out of 19 patients (10%), that needed surgical revision after trabeculectomy with adjunctive mitomycin C in patients with uncontrolled intraocular pressure after glaucoma drainage device implantation.
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