Non-enhanced trabeculectomy by non-glaucoma specialists: are results related to risk factors for failure?

ABSTRACT _Purpose_ To determine the 1 year success rate of non-enhanced trabeculectomy under the care of non-glaucoma specialists and the effects of risk factors on the surgical outcome as

measured by intraocular pressure (IOP) control. _Methods_ A retrospective study of 167 patients undergoing trabeculectomy was performed. One hundred and four cases were performed in a

teaching hospital and 63 in a district general hospital (DGH). Non-glaucoma specialists performed all the operations, enhanced trabeculectomy with antimetabolites being excluded. Information

was recorded from a retrospective review of case notes, and post-operative IOPs at 12 months follow-up were analysed. Risk factors for failure were defined as: (1) age less than 40 years

old, (2) black race, (3) diabetes mellitus, (4) miotic therapy 18 months, (5) sympathomimetic therapy 6 months, (6) pseudophakia or aphakia, (7) previous failed filtration procedure, (8)

argon laser trabeculoplasty, (9) previous ocular surgery and (10) high-risk glaucoma (angle recession glaucoma, uveitic flaucoma and neovascular glaucoma). A iuccess was defined to be a

post-operative IOP at 1 year of less than 21 mmHg and at least 20% less than the presenting IOP on no medication. _Results_ The overall success rate was 139 of 167 (83.2%). Eighty-seven of

104 eyes (83.7%) were Classified as a success in the teaching hospital group and 52 of 63 (82.5%) were classified as a success in the DGH group. There was no significant difference in the

number of risk factors between the success and failure groups. Eyes with two or more risk factors had significantly higher IOPs at 1 year when compared with eyes with 0 or 1 risk factor

(mean ± SD: 17.4 ± 6.34 mmHg vs 14.2 ± 5.0 mmHg, _p_ = 0.022). When only ‘successful eyes’ were analysed, those with two or more risk factors still had significantly higher IOPs at 1 year

(mean ± SD: 15.0 ± 3.0 mmHg vs 12.8 ± 3.9 mmHg, _p_ = 0.046). There were significantly fewer eyes in the two or more risk factor group with IOPs < 16 mmHg at 1 year (26.1% vs 60.4%, _p_ =

0.021). _Conclusions_ Eyes at relatively low risk for failure operated upon by non-glaucoma specialists appeared to have success rates similar to previously published series. Eyes with two

or more risk factors for failure have higher IOPs at 1 year in non-enchanced trabeculectomy. Adjunctive anti-scarring agents may be considered for these patients when filtration surgery is

scheduled. SIMILAR CONTENT BEING VIEWED BY OTHERS ONE-YEAR RESULTS OF TWO-SITE TRABECULOTOMY IN PAEDIATRIC GLAUCOMA FOLLOWING CATARACT SURGERY Article 21 August 2020 A RETROSPECTIVE REVIEW

OF SELECTIVE LASER TRABECULOPLASTY OUTCOMES AT LANCASHIRE TEACHING HOSPITALS, UK Article 28 August 2024 THE SAFETY AND EFFECTIVENESS OF OPTOMETRIST-DELIVERED SELECTIVE LASER TRABECULOPLASTY

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references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Ophthalmology, Queen's Medical Centre, University Hospital, Nottingham, UK V C T Sung, T K H Butler & S A

Vernon Authors * V C T Sung View author publications You can also search for this author inPubMed Google Scholar * T K H Butler View author publications You can also search for this author

inPubMed Google Scholar * S A Vernon View author publications You can also search for this author inPubMed Google Scholar ADDITIONAL INFORMATION This paper was partly presented as a poster

at the Annual Congress of the Royal College of Ophthalmologists, Cardiff, 1999 RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Sung, V., Butler, T. &

Vernon, S. Non-enhanced trabeculectomy by non-glaucoma specialists: Are results related to risk factors for failure?. _Eye_ 15, 45–51 (2001). https://doi.org/10.1038/eye.2001.12 Download

citation * Received: 17 August 1999 * Accepted: 12 April 2000 * Issue Date: 01 January 2001 * DOI: https://doi.org/10.1038/eye.2001.12 SHARE THIS ARTICLE Anyone you share the following link

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content-sharing initiative KEYWORDS * District general hospital * Glaucoma * Intraocular pressure * Risk factor * Specialists * Trabeculectomy * Teaching hospital