Long‐term outcome following trabeculectomy: I

Abstract

Decrease of intraocular pressure (IOP) and the occurrence of cataract were analysed in 75 patients of a community-based material followed for 6-12 years after trabeculectomy. IOP was controlled (less than or equal to 21 mmHg) with or without additional treatment in approximately 90% of the eyes, both at 5 years and at the last visit. The share of eyes requiring no medication for IOP control decreased linearly with time from approximately 90 to 60% between one and 10 years postoperatively. Thirty-eight per cent of the patients without cataract at the time of operation suffered from cataract development during follow-up. The prevalence of dense cataract producing severe visual loss at the last visit was 47%. The occurrence of cataract was correlated with the age of patients at operation. Cataract formation showed no relationship of statistical significance with preoperative treatment, with time since surgery, the magnitude of preoperative IOP and the reduction of postoperative IOP.

Development of cataract after trabeculectomy

“…Age might have some effect: accelerated cataract progression (increase in LOV) was shown after the age of 61 years. Bonomi et al (1989) and Popovic & Sjostrand (1991) have reported similar results.…”

“…The progression of cataract after trabeculectomy has been widely discussed. The major cause of controversy has been the difficulty of objective evaluation of the degree of cataract and its progression uay & Murray 1988; Bonomi et al 1989;Watson et al 1990;Popovic & Sjostrand 1991). There are no uniform criteria for cataract extraction, but the decision is a clinical one, based upon the patient's need for vision.…”

Long-Term Intraocular Pressure Control of Trabeculectomy and Triple Procedure in Primary Open Angle Glaucoma and Chronic Primary Angle Closure Glaucoma

“…Trabeculectomy has been the most common filtering surgery for the treatment of patients with glaucoma for several decades [1,2,3,4,5,6,7,8,9,10]. Antifibrotic agents such as mitomycin C (MMC) have been used in conjunction with both trabeculectomy and triple procedure for wound healing modulation since the early 1980s [11,12,13,14].…”

“…Several studies have shown trabeculectomy and triple procedure to be effective in short- and long-term control of intraocular pressure (IOP) [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19], yet few reports appear in the literature regarding the long-term outcome of the triple procedure or comparisons of long-term results between trabeculectomy and triple procedure.…”

Deterioration of filtering bleb morphology and function after phacoemulsification

“…Cataract, which is the most frequent late complication of trabeculectomy, constitutes an important problem concerning, according to different sources, from several to several dozen per cent of patients after a filtering surgery [12,13]. It has been shown that the filtration procedure itself may speed up the formation of lens opacity, for example in eyes with postoperative hypotony, shallow anterior chamber, or intense inflammation [14-17].…”