Comparative study of Watson's and Cairns's trabeculectomies in a Black population with open angle glaucoma.

Abstract

(Iliff, 1944;Berson et al., 1966; Welsh, 1969;and Luntz, 1965 (Luntz, 1965), trabeculectomy has the advantage of fewer postoperative complications. Materials and methodsA total of 34 patients-22 males and 12 femalestheir ages ranging from 35 to 75, had surgical treatment. There were 49 eyes on which 61 trabeculectomies were performed. All the patients were seen at the Glaucoma Clinic, St. John Eye Hospital, Baragwanath, and underwent trabeculectomy between 1 January 1974 and 31 December 1975. In all these patients medical treatment failed to control their glaucoma. Failure was judged by con-

Post-operative complication of trabeculectomy in Ibadan, Nigeria: outcome of 1-year follow-up

“…4 Also, trabeculectomy has been reported to be more beneficial in Africans in term of IOP lowering effect and slowing down of field loss. [5][6][7] The goal of the surgery is to establish a permanent flow of aqueous from the anterior chamber to the subconjuctival space thereby lowering the IOP.…”

Trabeculectomy in Nigerian patients with open-angle glaucoma.

“…Chatterjee and Ansari (1972) and David et al (1977) achieved 7922% and 91 6% success, respectively, with trabeculectomy without accessory procedures in the African. In this (1976) Non-suturing of scleral flap, postoperative antiglaucoma medication 82 0 Fergusson and MacDonald (1977) Loose approximation, high steroids, postoperative antiglaucoma medication 84-0 David et al (1977) With and without antiglaucoma medication 91t0 Sandford-Smith (1978) Non-suturing, minimum suturing, large excision of internal flap same size as external flap 87-0 Schimek and Williamson (1977) Cautery of posterior lip and posteriorly of inner scleral layer 83-0 Present authors Standardised trabeculectomy only 95 4 study control of IOP was observed in 95*4% of the eyes after a standardised operation, and there was no postoperative antiglaucoma medication or steroids. The results of this study and those of various authors in African glaucoma population are shown in Table 8.…”

“…This has been achieved by following a standardised procedure and without recourse to accessory surgical means, such as excising Tenon's capsule (Welsh, 1972;Keitzman, 1976), non-suturing, loose suturing, or minimal suturing of the scleral flap (Welsh, 1972;Keitzman, 1976;Freedman et al, 1976;Fergusson and MacDonald, 1977;Sandford-Smith, 1978), excision of part of the scleral flap (sclerectomy), iris incarceration (Welsh, 1972), intentional cyclodialysis (Galin et al, 1975), cauterisation of posterior lip and the inner flap (Schimek and Williamson, 1977), very large resection of internal flap of the same measurements as the exterior flap (Keitzman, 1976;Sandford-Smith, 1978), and without recourse to medical measures such as high doses of systemic corticosteroids and/or subconjunctival depot steroids (Fergusson and MacDonald, 1977) and postoperative antiglaucoma medication in those cases not completely controlled (Freedman et al, 1976;Fergusson and MacDonald, 1977;David et al, 1977;Sandford-Smith, 1978). Before this study, such modifications to trabeculectomy procedures were undertaken because of the concept that filtration procedures often produced failures in the African patient (Welsh, 1970).…”

“…A magnification 2-5 times is sufficient for a properly and carefully executed trabeculectomy, as shown by this study, in which an operating loupe of 2-5 times was routinely used with excellent results. This means that trabeculectomy is within the capacity of the average ophthalmic surgeon to the great benefit of glaucoma sufferers, for the operation has proved to be the method of choice par excellence in the surgical management of glaucoma in both the African and the white races (Ridgway et al, 1972;Freedman et al, 1976;David et al, 1977).…”

“…or adding a regimen of high doses of corticosteroids (Fergusson and MacDonald, 1977). Favourable results, however, have been reported from trabeculectomy without such measures (Chatterjee and Ansari, 1972;David et al, 1977).…”