Effects of early postoperative complications and the location of trephined block on long-term intraocular pressure control after trabeculectomy

Ehrnrooth, Pia; Lehto, Ilkka; Puska, Päivi; Laatikainen, Leila

doi:10.1007/s00417-003-0756-z

Cited by 9 publications

(3 citation statements)

References 21 publications

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“…This series confirmed trabeculectomy as being a safe operation with a low rate of postoperative complications. Early postoperative hypotony (38%) was within the range of 24–39% reported in various studies using differing definitions 20–23 . In this series early postoperative hypotony was not associated with an increased rate of failure, which concurs with some 20,21 but not all reports 22,23 …”

Section: Discussionsupporting

confidence: 79%

Otago Glaucoma Surgery Outcome Study: long‐term results of 841 trabeculectomies

Bevin

Molteno

Herbison

2008

Clinical Exper Ophthalmology

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Section: Discussionsupporting

confidence: 79%

Otago Glaucoma Surgery Outcome Study: long‐term results of 841 trabeculectomies

Bevin

Molteno

Herbison

2008

Clinical Exper Ophthalmology

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“…The mean follow‐up period was 3.5 years (range 2–5 years). The surgical technique used in the trabeculectomy and the postoperative complications have been described in detail in Ehrnrooth et al (2002, 2003).…”

Section: Methodsmentioning

confidence: 99%

Phacoemulsification in trabeculectomized eyes

Ehrnrooth

Lehto

Puska

et al. 2005

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To evaluate retrospectively risk indicators for cataract surgery and the effect of phacoemulsification on intraocular pressure (IOP) control in eyes that have undergone trabeculectomy. Methods: We undertook a retrospective analysis of 138 eyes with primary openangle glaucoma (POAG) or exfoliation glaucoma (EG) in 138 consecutive patients over the age of 40 years undergoing trabeculectomy with no antimetabolites performed by one surgeon. Of the 48 eyes (35%) undergoing a cataract operation during the follow-up period of 2-5 years, 46 were included in this analysis. Their IOP, glaucoma medication and best corrected visual acuity (BCVA) before cataract surgery and at the last follow-up were compared. Risk indicators for cataract surgery were analysed. Results: Cataract operations were performed 5.1-58.1 months (median 14.4 months) after trabeculectomy. The mean length of follow-up after cataract surgery was 25.3 months (SD 12.9, median 24.8 months). Before cataract surgery, the mean IOP was 16.2 mmHg (SD 4.9) and the mean number of topical antiglaucoma medicines 0.8 (SD 1.0). At the most recent visit, mean IOP was 17.3 mmHg (SD 6.4) (p = 0.35), and the mean number of medicines was 1.3 (SD 1.1) (p = 0.0007). Of the 22 eyes in which treatment had been categorized as completely successful (IOP £ 21 mmHg without other therapy) before cataract surgery, 13 (59%) had remained so. The number of failures (IOP > 21 mmHg, or more than one medication needed or further surgery performed) increased from 14 (30%) before surgery to 28 (61%) afterwards. The proportion of failures in the cataract surgery group was twice that in the no cataract surgery group (61% versus 31%). In a proportional hazards regression, only age (73.9 years [SD 9.4] and 68.1 years [SD 9.8] in patients with and without cataract surgery, respectively) proved to be a significant (p = 0.001) indicator for surgery. Conclusion:The results of this retrospective study on consecutive clinical cases of trabeculectomy indicate that cataract progression after trabeculectomy is mainly an age-related process. In more than half the eyes with good preoperative IOP control, this good control was maintained after cataract surgery. On the other hand, in some eyes cataract surgery may compromise IOP control even when surgery avoids the area of the bleb.

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“…The occurrence of postoperative complications in eyes with VF progression corresponds to the figures presented for the whole study group in our previous paper [8]: 50% of the eyes with VF progression had received laser suturolysis, 21% had early postoperative IOP elevation >30 mmHg, and 18% had hyphaema. Hypotony (12%), shallow/flat anterior chamber (6%) and choroidal detachment (15%) were less common than in the whole series (25%, 15%, 21%, respectively).…”

Section: Resultsmentioning

confidence: 82%

Progression of visual field defects and visual loss in trabeculectomized eyes

Ehrnrooth

Puska

Lehto

et al. 2005

Graefe's Arch Clin Exp Ophthalmol

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Progression of VF defects and development of visual impairment due to glaucoma was fairly common despite trabeculectomy. Both were associated with severity of initial VF defect. In this series, no significant correlation appeared between defect progression and the last IOP, but association between stability of VF and the amount of IOP reduction after surgery indicate that a lower target IOP level particularly in eyes with initially severe VF defect would, however, be needed.

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Effects of early postoperative complications and the location of trephined block on long-term intraocular pressure control after trabeculectomy

Abstract: Early postoperative complications after trabeculectomy were common, but the only significant predictor of failure was increased intraocular pressure at the end of the 1st postoperative month.

Cited by 9 publications

References 21 publications

Otago Glaucoma Surgery Outcome Study: long‐term results of 841 trabeculectomies

Otago Glaucoma Surgery Outcome Study: long‐term results of 841 trabeculectomies

Phacoemulsification in trabeculectomized eyes

Progression of visual field defects and visual loss in trabeculectomized eyes

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