A review of trabeculectomies at a Nigerian teaching Hospital

Adegbehingbe, BO; Majemgbasan, T O

doi:10.4314/gmj.v41i4.55287

Cited by 17 publications

(34 citation statements)

References 16 publications

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“…This is a relatively high proportion compared with 8.2% found by Adegbehingbe8 in Ile-Ife, Nigeria; 32.5% by Omoti et al .,10 in Benin city, Nigeria; 46.8% by Onyekwe et al .,15 in Onitsha, Nigeria, and 48% by Mafwiri et al .,16 in Tanzania. The high acceptance rate in this study might be related to the verbal consent method of assessing acceptance, and not whether the patient actually returned for surgery.…”

Section: Discussionmentioning

confidence: 67%

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Patient refusal of glaucoma surgery and associated factors in lagos, Nigeria

Adekoya

Akinsola

Balogun

et al. 2013

Middle East Afr J Ophthalmol

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Purpose:To determine the prevalence of patient refusal of glaucoma surgery (GSR) and the associated factors in Lagos, Nigeria.Materials and Methods:A multicenter cross-sectional survey was conducted in Lagos state, Nigeria. Twelve centres were invited to participate, but data collection was completed in 10. Newly diagnosed glaucoma patients were recruited and interviewed from these sites over a four week period on prior awareness of glaucoma, surgery refusal, and reason(s) for the refusal. Presenting visual acuity was recorded from the patient files. The odds ratio and 95% confidence intervals (CI) were calculated.Results:A total of 208 newly diagnosed glaucoma patients were recruited. Sixty–five (31.2%) patients refused surgery. Fear of surgery (31 (47.7%) patients), and fear of going blind (19 (29.2%) patients) were the most common reasons. The odds ratio of surgery refusal were marital status – not married versus married (2.0; 95% CI, 1.02–3.94), use of traditional medication – users versus non users (2.4; 95% CI, 1.1–5.2), perception of glaucoma causing blindness – no versus yes (3.7; 95% CI, 1.3–10.5), type of institution - government versus private (5.7; 95% CI, 1.3–25.1), and visual acuity in the better eye - normal vision versus visual impairment (2.3; 95% CI, 1.1–4.9). Age, gender, level of education, family history of glaucoma, and prior awareness of the diagnosis of glaucoma, were not significantly associated with surgery refusal. Perception of patients concerning glaucoma blindness was the strongest factor on multivariate analysis.Conclusion:GSR was relatively low in this study. Unmarried status, use of traditional medications, perception that glaucoma cannot cause blindness, government hospital patients, and good vision in the better eye were associated with GSR. These factors might help in the clinical setting in identifying appropriate individuals for targeted counseling, as well as the need for increased public awareness about glaucoma.

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Section: Discussionmentioning

confidence: 67%

“…Despite this recommendation, rates of glaucoma surgery remain low8 in Nigeria. One of the contributing factors is the low rate of acceptance of glaucoma surgery among eligible patients.…”

Section: Introductionmentioning

confidence: 99%

Patient refusal of glaucoma surgery and associated factors in lagos, Nigeria

Adekoya

Akinsola

Balogun

et al. 2013

Middle East Afr J Ophthalmol

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“…Similarly, a study of 71 eyes of 63 patients showed postoperative IOP of 10–15 mmHg in 82% of cases during follow up period [14]. A study of 46 patients who had the procedure with mean pre-operative IOP of 32.5 ± 6.2 mmHg showed reduction to 14.6 ± 4.2 and 13.5 ± 5.8 mmHg at 3 months and one year, respectively [47]. A study of 100 patients which defined success as IOP less than 22 mmHg or reduction of 30% below preoperative level reported success in 85%, 82%, and 71% at 1, 2, and 5 year postoperative period, respectively [48].…”

Section: Treatment Of Poagmentioning

confidence: 99%

Epidemiological Properties of Primary Open Angle Glaucoma in Nigeria

Abdu

2013

Journal of Ophthalmology

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Background. Primary open angle glaucoma (POAG) is progressive chronic optic neuropathy in adults in which intraocular pressure (IOP) and other currently unknown factors contribute to damage. POAG is the second commonest cause of avoidable blindness in Nigeria. Pattern of Presentation. POAG is characterized by late presentation. Absence of pain which is a driving force for seeking medical help, inadequacy of trained eye care personnel, paucity of facilities, misdistribution of resources, lack of awareness, poor education, and poverty may all contribute to this. Medical and surgical treatment options available are challenging and tasking. Screening for Glaucoma. Screening is the presumptive identification of unrecognized disease (POAG) by applying test(s) which can be applied rapidly. Such test(s) should be of high reliability, validity, yield, acceptable, and cost effective. The test should ideally be sensitive, specific, and efficient. It is difficult to select a suitable test that meets these criteria. Intraocular pressure (IOP) appears to be the easiest option. But, high IOP is not diagnostic nor does normal value exclude the disease. Health education is a possible strategy in early case detection and management. Treatment of POAG. Glaucoma treatment can either be medical or surgical (this includes laser). Considering unavailability, potency, cost, and long-term effects of medication, surgery (trabeculectomy) could be a better option. Laser trabeculoplasty is available in a few centers. Viscocanalostomy is not routinely performed. Patient education is vital to success as management is for life. Conclusion. POAG remains a cause of avoidable blindness in Nigeria. There is need for long-term strategy to identify patients early and institute prompt management. Improvement in training of eye care personnel and provision of up to date equipment is essential in achieving this goal.

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“…An equally low output was observed in a retrospective review in south west Nigeria. 19 Not performing adequate number of glaucoma surgeries, especially in a tertiary teaching institution will have adverse effects on the training of resident doctors. Furthermore, this may create a vicious circle of low output, inadequate skills, poor results, and reduced uptake of glaucoma surgeries.…”

Section: Surgerymentioning

confidence: 99%

“…This is in agreement with the fact that this is the most common glaucoma operation in Africa. 14,19 The use of an antiscarring agent, such as 5FU and mitomycin C (MMC) is beneficial in reducing subconjunctival scarring 21,22 especially in the black population, and MMC has been found to result in lower pressures, 23,24 but the higher cost, higher toxicity, 11,25 low availability, and shorter shelf life are disadvantages. MMC was not used as an adjuvant in any of the centers during this study period.…”

Section: Surgerymentioning

confidence: 99%