Outcome of repeat trabeculectomies

Clin Exp Ophthalmol. 2011 Sep-Oct;39(7):658-64. doi: 10.1111/j.1442-9071.2011.02519.x. Epub 2011 Apr 4.

Abstract

Background: To determine the success of repeat trabeculectomy augmented with mitomycin C in a cohort of patients who had undergone previously failed trabeculectomy surgery.

Design: A consecutive cohort series of patients.

Participants: Fifty patients undergoing augmented trabeculectomy surgery following a previously failed trabeculectomy and at least 12 months' follow up.

Methods: All patients had demographic and clinical data collected at the time of surgery and at all subsequent follow-up visits.

Main outcome measures: Visual field progression, loss of visual acuity, intraocular pressure (IOP) control.

Results: The mean follow up was 36.7 months. Forty-one patients (82%) achieved an IOP ≤21 mmHg (with ≥20% reduction of preoperative IOP) and ≥6 mmHg on no additional glaucoma treatment at 12 months' follow up. Forty-four patients (88%) achieved a qualified success with the same criteria at 1 year. The median logMAR acuity preoperative was unchanged after surgery; however, 11 patients (22%) lost ≥2 Snellen lines during follow up. There was no significant change in mean deviation during the follow-up period.

Conclusions: Repeating trabeculectomy augmented with mitomycin C is an effective method of controlling IOP and preventing further visual deterioration in the majority of patients treated. However, visual loss was seen in a significant proportion of patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alkylating Agents / administration & dosage
  • Child
  • Female
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Postoperative Complications
  • Reoperation
  • Trabeculectomy*
  • Treatment Outcome
  • Visual Acuity / physiology
  • Visual Fields / physiology

Substances

  • Alkylating Agents
  • Mitomycin