Ocular Surface Complications after Trabeculectomy: Incidence, Risk Factors, Time Course and Prognosis

Ono, Takaaki; Yuki, Kenya; Ozeki, Naoki; Shiba, Daisuke; Tsubota, Kazuo

doi:10.1159/000351649

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…Trabeculectomy is known to lead to OSD [1,6]. Results from previous studies have led researchers to speculate on a relationship between OSD and meibomian gland loss and tear dysfunctions, including raised tear film osmolarity after trabeculectomy [5,6,8,30].…”

Section: Discussionmentioning

confidence: 99%

“…Results from previous studies have led researchers to speculate on a relationship between OSD and meibomian gland loss and tear dysfunctions, including raised tear film osmolarity after trabeculectomy [5,6,8,30]. If such a relationship does exist, the question remains as to why meibomian gland loss, tear dysfunction, and OSD occur after trabeculectomy.…”

Section: Discussionmentioning

confidence: 99%

“…However, the use of these antiproliferative agents may lead to tear film abnormalities and ocular surface complications, including defects in the conjunctival epithelium of the filtering bleb surface [1][2][3][4][5][6][7]. Defects in the conjunctival epithelium that covers the bleb wall are precursors to lateonset bleb leaks.…”

Section: Introductionmentioning

confidence: 99%

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Meibomian gland loss due to trabeculectomy

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Meibomian gland loss due to trabeculectomy

et al. 2014

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“…In addition, we found that trabeculectomy surgery was associated with a greater use of ocular lubricants postoperatively (74.0%) compared with phacoemulsification surgery (60.4%). One study found ocular surface complications including corneal epitheliopathy, filamentary keratitis and dellen in 15% of patients following trabeculectomy 36. One possible reason for OSD in these patients could be the use of MMC.…”

Section: Discussionmentioning

confidence: 99%

Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis

Iyer

Zhao

Lim

et al. 2017

OPTH

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BackgroundChronic use of intraocular pressure-lowering medications is associated with ocular surface disease (OSD). In this study, we assess the incidence of topical lubricant use as a surrogate marker for underlying OSD, in medically and surgically treated glaucoma patients.MethodsRetrospective chart review was performed for newly diagnosed glaucoma patients who were started on topical medications in 2007 and followed up over a 5-year period. Primary outcome measure was the incidence of topical lubricant use in these patients and a subset of these patients who required glaucoma or cataract surgery during follow-up.ResultsCharts of 505 newly diagnosed glaucoma patients with no prior history of ocular lubricant use were analyzed. Mean age was 63.9 years (SD 11.1), 42.8% were women. One hundred one (20.0%) patients underwent phacoemulsification surgery, 80 underwent mitomycin C (MMC) augmented phacotrabeculectomy, 16 underwent MMC-augmented trabeculectomy and 3 underwent tube surgery during the course of follow-up as their only type of surgery. Five-year incidence of lubricant use was 59% in all glaucoma subjects; 54.1% of patients were on medical treatment and 74.0% of patients who underwent phacotrabeculectomy or trabeculectomy were started on lubricants, respectively (P=0.0011); 60.4% of glaucoma subjects who underwent phacoemulsification surgery were started on lubricants. Incidence of lubricant use increased from 17.7% preoperatively to 74.0% postoperatively in subjects who required trabeculectomy or phacotrabeculectomy. Incidence of lubricant use was similar in patients on one or multiple glaucoma medications, with the mean onset of lubricant use being 10 months after starting glaucoma medication in both groups. Females were more likely to use artificial tears compared with males (P=0.002).ConclusionBoth medical and surgical management of glaucoma have an adverse effect on the ocular surface. Chronic use of glaucoma medications was associated with a high incidence of ocular lubricant use. MMC-augmented trabeculectomy was associated with an even higher incidence of ocular lubricant use.

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“… 2 On the other hand, ocular surface complications following trabeculectomy with MMC are fairly common. 10 …”

Section: Discussionmentioning

confidence: 99%

Treatment with sodium hyaluronate eye drops in a patient who had early-onset bleb leakage after trabeculectomy with mitomycin C

Sagara

Sekiryu

Noji

et al. 2015

IMCRJ

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We present the case of a 47-year-old man who had bilateral proliferative diabetic retinopathy and neovascular glaucoma. Schirmer I test revealed tear secretions of 5 mm and 3 mm in the right and left eyes, respectively. Tear breakup times in the right and left eyes were 7 and 8 seconds, respectively. The ocular surface staining in both eyes was scored as Grade 1 as per the Oxford scheme. Retinal photocoagulation was performed for correction of the proliferative diabetic retinopathy and rubeosis iridis, which resolved with treatment. However, the intraocular pressure in the left eye could not be adequately controlled. Therefore, trabeculectomy with mitomycin C using limbal-based conjunctival flap was performed. Three hours after the surgery, the patient developed a large and diffuse filtering bleb, but no leakage occurred from the conjunctival scar. However, on the first postoperative day, leakage was noted and the conjunctiva was at the leakage point. The leakage resolved transiently, but recurred the next day. Severe keratoconjunctival epithelial failure was detected, and the patient was administrated 0.1% sodium hyaluronate eye drops six times daily. The epithelial failure improved, and many microcysts were detected on the bleb surface where the epithelial failure improved. The leakage resolved 2 days after initiation of the sodium hyaluronate eye drops. The microcysts disappeared and the bleb surface became smooth 1 month later.

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Ocular Surface Complications after Trabeculectomy: Incidence, Risk Factors, Time Course and Prognosis

Cited by 19 publications

References 25 publications

Meibomian gland loss due to trabeculectomy

Meibomian gland loss due to trabeculectomy

Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis

Treatment with sodium hyaluronate eye drops in a patient who had early-onset bleb leakage after trabeculectomy with mitomycin C

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