Five-year Follow-up of the Fluorouracil Filtering Surgery Study

Schiffman, Joyce C.; Alward, Wallace L.M.; Farrell, Thomas A.; Hayreh, Sohan Singh; Kolder, Hansjoerg E.; Carney, Benita L.; Phelps, Charles D.; Gressel, Michael G.; Costin, John A.; Craven, P.; Zgrabik, Michael; Schremp, Pamela S.; Simashkevich, B.; Heuer, Dale K.; Baerveldt, George; Minckler, Don S.; Irvine, John A.; Green, R.; McDonnell, Peter J.

doi:10.1016/s0002-9394(14)70431-3

Cited by 397 publications

(13 citation statements)

References 17 publications

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“…It must be pointed out that mean duration of 12 months follow-up is comparatively shorter when it is known for success rate to decline with time after filtering surgery. [22][23][24] Higher rates of shallow anterior chamber were reported in 13% 20,21 compared with 4.5% in our current study. Similarly, 13% 20,21 of choroidal detachment was seen compared to nil in our study.…”

Section: Discussioncontrasting

confidence: 45%

<p>Outcome and Complications of Combined Modified Deep Sclerectomy and Trabeculectomy for Surgical Management of Glaucoma: A Pilot Study</p>

Sangtam¹,

Roy²,

Mermoud³

2020

OPTH

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Video abstractPoint your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use:https://youtu.be/a82NJoWmPLgPurpose: To report the outcome and complications of a combined surgical technique of modified deep sclerectomy and trabeculectomy (mDST) for glaucoma.Patients and Methods: Retrospective study of 44 eyes of 43 patients with open and closed angle glaucoma who underwent mDST. Outcome measures were: Surgical Success with 3 criteria -(i) criterion 1 = intraocular pressure (IOP) ≤21 mmHg or reduced by ≥20% of preoperative IOP or IOP ≥6 mmHg on 2 consecutive time points after 3 months; (ii) criterion 2 = IOP ≤18 mmHg or reduced by ≥30% of pre-operative IOP or IOP ≥6 mmHg on 2 consecutive time points after 3 months and (iii) criterion 3 = IOP ≤15 mmHg or reduced by ≥40% of preoperative IOP or IOP ≥6 mmHg on 2 consecutive time points after 3 months; IOP Reduction; Use of Anti-glaucoma Medication; Complications; Visual Acuity and Postoperative Interventions.Results: Median follow-up was 40 months (range 24-77 months). At the final follow-up visit, the mean postoperative IOP was 11.5 ± 4.7 mmHg (p<0.0001). Mean number of antiglaucoma medications decreased from 2.45 ± 1.21 to 0.54 ± 0.95 (p<0.0001). Surgical success in terms of IOP reduction was 50%; 43.2%; 36.4% for the 3 criteria respectively (complete success) and 70.5%; 56.8%; 47.7% for the 3 criteria respectively (qualified success). The complications noted were shallow/flat anterior chamber in 2 (4.54%), hyphema & bleb leak in 3 (6.81%), aqueous misdirection in 1 (2.27%), hypotonic maculopathy in 2 (4.45%) and hypotony requiring intervention in 6 (13.63%) eyes. Conclusion: Combined mDST was found to be an effective surgical procedure in reducing IOP. It was associated with complications commonly encountered in glaucoma filtering surgery. The use of intra-scleral space maintainer may help lower the risk of flat or shallow anterior chamber during the early postoperative period.

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Section: Discussioncontrasting

confidence: 45%

<p>Outcome and Complications of Combined Modified Deep Sclerectomy and Trabeculectomy for Surgical Management of Glaucoma: A Pilot Study</p>

Sangtam¹,

Roy²,

Mermoud³

2020

OPTH

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“…There are few studies examining the effect of trabeculectomy on diabetic eyes with DM, but the results are conflicting [1–2, 12–14]. Some studies reported that DM was associated with poorer outcome in trabeculectomy [1, 2, 12, 13].…”

Section: Discussionmentioning

confidence: 99%

“…Some studies reported that DM was associated with poorer outcome in trabeculectomy [1, 2, 12, 13]. However, the Fluorouracil Filtering Surgery Study showed that diabetic status was not associated with poorer outcome in trabeculectomy [14]. …”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Primary Trabeculectomy in Diabetic Patients without Retinopathy with Primary Angle-Closure Glaucoma

Liu

Zhang

et al. 2017

Journal of Ophthalmology

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Purpose. To evaluate primary trabeculectomy with adjunctive mitomycin-C (MMC) in diabetic patients without retinopathy with primary angle-closure glaucoma (PACG). Design. This is a retrospective case series comparison. Participants. This retrospective trial compared outcomes of 88 eyes that underwent trabeculectomy in patients with diabetes mellitus (DM) without retinopathy and in 97 patients without DM. Methods. In this study, the intraocular pressure (IOP), visual acuity, visual field, and postoperative complications were compared between the two groups. Qualified surgical success is defined as an IOP between 6 and 18 mmHg with or without topical antiglaucoma medication. Results. After a follow-up of 5 years, the IOP decreased from a mean basal IOP of 27.8 ± 7.3 mmHg to 15.0 ± 5.6 mmHg in the DM group and from 27.3 ± 6.0 mmHg to 12.4 ± 5.3 mmHg in the control group. The mean number of antiglaucoma medications was 3.4 ± 1.3 and 3.3 ± 1.2 preoperatively (P = 0.587) whereas it was 1.7 ± 1.5 and 1.1 ± 1.4 at the 5-year follow-up (P = 0.049). The 5-year qualified surgical success rates were 42.9% and 65.4% for both groups (P = 0.046; log-rank test). Encysted blebs were seen in 21 (23.9%) patients in the DM group and in 12 (12.4%) patients in the control group (P = 0.041). Conclusion. PACG patients with DM without retinopathy undergoing primary trabeculectomy with MMC may have a lower long-term surgical survival rate compared with patients without DM.

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“…On the other hand, several surgical techniques have been associated with reduced failure rate, including superonasal location of scleral flap [ 10 ] and intraoperative use of mitomycin C [ 2 – 4 , 8 , 11 ]. However, the type of conjunctival flap isn’t known to affect the success rate, as some studies showed better success rates with limbus-based conjunctival flap compared to fornix-based, while others reported similar success rates between the two [ 12 ].…”

mentioning

confidence: 99%

“…Postoperatively, the use of subconjunctival 5-fluorouracil injection and the performance of laser suture lysis has been associated with improved success rates [ 4 , 12 ]. Therefore, identifying the risk factors for trabeculectomy failure will aid clinicians to institute prompt intervention within the perioperative period to increase chances for success.…”

mentioning

confidence: 99%

Efficacy and Safety of Sutureless Trabeculectomy with Using Porous Collagen (Ologen) in Management of Glaucoma Patients

Elbably¹,

Rezq²,

ElDakkak³

et al. 2021

Korean J Ophthalmol

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Aim of the Work:This study aims to investigate the safety, efficacy and feasibility of trabeculectomy using a porous Collagen Matrix that contains a connected porous structure (Ologen ® ) in the control of IOP in glaucoma patients without the need for medical therapy. Methods:The study includes 25 eyes from 24 patients that met the inclusion criteria. All eyes underwent trabeculectomy with the Ologen ® implant that provides a space with a dynamic and physiological aqueous reservoir system. The operation was considered successful if IOP is <15mmHg without need of IOPlowering drops at 18 months of follow up. Results:The target IOP was achieved in 21 out of the 25 eyes (84%), the remaining four eyes all had an IOP of 16 mmHg at 18 months. Short-term complications consisted of seven cases of bleb leakage treated with bandage contact lens and one case of mild choroidal effusion which resolved after observation alone. Conclusions:We can conclude that this technique can provide safety, effectiveness and short learning curve for ophthalmology trainees with lower incidence of peri-operative and post-operative complications.Further studies may be required to prove stability and long-term efficacy in management of glaucoma patients.

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Five-year Follow-up of the Fluorouracil Filtering Surgery Study

Cited by 397 publications

References 17 publications

<p>Outcome and Complications of Combined Modified Deep Sclerectomy and Trabeculectomy for Surgical Management of Glaucoma: A Pilot Study</p>

<p>Outcome and Complications of Combined Modified Deep Sclerectomy and Trabeculectomy for Surgical Management of Glaucoma: A Pilot Study</p>

Long-Term Outcomes of Primary Trabeculectomy in Diabetic Patients without Retinopathy with Primary Angle-Closure Glaucoma

Efficacy and Safety of Sutureless Trabeculectomy with Using Porous Collagen (Ologen) in Management of Glaucoma Patients

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