Long-term outcomes of primary trabeculectomy in diabetic patients with primary open angle glaucoma

Law, Simon K.; Hosseini, Hamid; Saidi, Elham; Nassiri, Nariman; Neelakanta, Gundappa; Giaconi, JoAnn A.

doi:10.1136/bjophthalmol-2012-302227

Cited by 23 publications

(17 citation statements)

References 18 publications

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“…The surgical outcomes have been extensively studied for classic trabeculectomy and argon laser trabeculoplasty (ALT), but the literature is sparse when we look for newer procedures, such as the nonpenetrating sclerectomy or drainage devices. 30 - 33 …”

Section: Is Diabetes a Risk Factor To Glaucoma Surgical Outcomes?mentioning

confidence: 99%

See 1 more Smart Citation

Diabetes Mellitus as a Risk Factor in Glaucoma\'s Physiopathology and Surgical Survival Time: A Literature Review

Costa¹,

Cunha²,

Amado³

et al. 2015

Journal of Current Glaucoma Practice

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Glaucoma is a multifactorial condition under serious influence of many risk factors. The role of diabetes mellitus (DM) in glaucoma etiology or progression remains inconclusive. Although, the diabetic patients have different healing mechanism comparing to the general population and it has a possible-negative role on surgical outcomes.This review article attempts to analyze the association of both diseases, glaucoma and DM, before and after the surgery.The epidemiological studies, based mainly in population prevalence analyzes, have shown opposite outcomes in time and even in the most recent articles also the association remains inconclusive. On the contrary, the experimental models based on animal induced chronic hyperglycemia have shown an important association of both diseases, explained by common neurodegenerative mechanisms.Diabetic patients have a different wound healing process in the eye viz-a-viz other organs. The healing process is more and it results in lower surgical survival time, higher intraocular pressure (IOP) levels and, therefore, these patients usually need more medication to lower the IOP. Both randomized and nonrandomized retrospective and experimental molecular studies have shown the association between DM and glaucoma.Further studies are needed to get better explanations about outcomes on more recent surgical procedures and with the exponential use of antifibrotics.How to cite this article: Costa L, Cunha JP, Amado D, Pinto LA, Ferreira J. Diabetes Mellitus as a Risk Factor in Glaucoma’s Physiopathology and Surgical Survival Time: A Literature Review. J Curr Glaucoma Pract 2015;9(3):81-85.

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Section: Is Diabetes a Risk Factor To Glaucoma Surgical Outcomes?mentioning

confidence: 99%

“…Literature has a huge diversity of articles considering these conclusions in varied group of patients, such as proliferative diabetic retinopathy, no proliferative diabetic retinopathy in progression or diabetes without retinopathy. 30 - 33 …”

Section: Is Diabetes a Risk Factor To Glaucoma Surgical Outcomes?mentioning

confidence: 99%

Diabetes Mellitus as a Risk Factor in Glaucoma\'s Physiopathology and Surgical Survival Time: A Literature Review

Costa¹,

Cunha²,

Amado³

et al. 2015

Journal of Current Glaucoma Practice

View full text Add to dashboard Cite

show abstract

“…These contradictory findings, taken together with the equivocal findings of Law et al ,4 may indicate that diabetes is not a major risk factor for trabeculectomy failure on the same order as prior failed filtering surgery or neovascular glaucoma; but nonetheless, it should be taken into consideration at the time of surgery, for example, when the surgeon is deciding whether to apply mitomycin for the usual amount of time, versus an increased application time in order to offset a history of diabetes, even without retinopathy. Further comparative and/or prospective reports on filtering surgery success in diabetics, with documentation of blood glucose control and retinopathy status, and using the longer mitomycin application times that are more typically used by many glaucoma surgeons are welcome, given the impending wave of diabetic patients that awaits us in the future.…”

mentioning

confidence: 90%

“…Law and colleagues4 report on a case–control study of diabetic eyes without retinopathy that underwent primary trabeculectomy by the same two surgeons. Both groups received adjunctive intraoperative mitomycin at the time of surgery for a relatively short duration (average about 1 min—about half the dose typically used by the American Glaucoma Society members in primary trabeculectomy) 5.…”

mentioning

confidence: 99%

Is diabetes, even without retinopathy, a risk factor for glaucoma filtering surgery failure in the age of anti-fibrosis agents?

Chen

2013

Br J Ophthalmol

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“…However, published data were mainly focused on trabeculectomy in diabetic eyes with proliferative disease or with different stages of diabetic retinopathy [4–6]. Law et al reported the long-term outcomes of primary trabeculectomy with mitomycin-C (MMC) in diabetic patients without retinopathy with primary open-angle glaucoma (POAG) [7]. The result indicated that POAG patients with DM without retinopathy undergoing primary trabeculectomy may have a lower long-term surgical survival rate compared with patients without DM.…”

Section: Introductionmentioning

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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Long-term outcomes of primary trabeculectomy in diabetic patients with primary open angle glaucoma

Abstract: POAG patients with DM without retinopathy undergoing primary trabeculectomy with MMC do not achieve the same long-term IOP control and may have a lower long-term surgical survival rate compared with patients without DM.

Cited by 23 publications

References 18 publications

Diabetes Mellitus as a Risk Factor in Glaucoma\'s Physiopathology and Surgical Survival Time: A Literature Review

Diabetes Mellitus as a Risk Factor in Glaucoma\'s Physiopathology and Surgical Survival Time: A Literature Review

Is diabetes, even without retinopathy, a risk factor for glaucoma filtering surgery failure in the age of anti-fibrosis agents?

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

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