Nachbetreuung von Trabekulektomien

Abstract

An intensive follow-up after trabeculectomy is mandatory to avoid postoperative failure. In about half of the patients postoperative additional therapeutic measures became necessary, particularly if scarring of the filtering bleb occurred. Paying attention to these factors yields in a high success rate after filtering surgery.

Evaluation of filtering blebs using the ‘Wuerzburg bleb classification score’ compared to clinical findings

“…This result is comparable with other studies, which report similar success rates (between 73.9% and 76%) using the same definition of success [3,25,39]. …”

“…Long-term success depends on preoperative and intraoperative conditions, but long-term success also highly depends on the persistence of filtration efficiency at the bleb site. Therefore, postoperative observation and care of the developing filtering bleb in clinical practice is an important tool in reaching the target pressure after filtration surgery in a higher percentage of the patients [2,3]. …”

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

“…Similar [1,15,19] or somewhat lower [14] complication rates have been reported previously. In our glaucoma population the proportion of EG is greater than in most of the other series reported.…”

Filtering Bleb Evaluation with Slit-Lamp–Adapted 1310-nm Optical Coherence Tomography

“…8−14 A successful outcome of filtering surgery is very much dependent on the healing process of the filtering bleb. 15,16 With the use of antimetabolites, the high scarring rate already can be lowered. 17,18 Nevertheless, scarring of the filtering bleb is still a major problem as is the timing of appropriate postoperative intervention in the ongoing scarring process.…”

“…A very close and frequent postoperative control augmented the success rate of filtering glaucoma surgery up to 88.5%, when adjacent surgical intervention (e.g., 5-fluorouracil injection) in the postoperative course was performed in 41% of the cases. 16 However, slit-lamp-based assessment of the filtering bleb is a subjective method depending on the experience of the examiner. Therefore, the need for an objective imaging device for filtering blebs is mandatory.…”