Outcomes and risk factors for failure after trabeculectomy in Taiwanese patients: medical chart reviews from 2006 to 2017

Chiu, Hsun-I; Su, Huan; Ko, Yu Chieh; Liu, Catherine Jui Ling

doi:10.1136/bjophthalmol-2020-317303

Cited by 9 publications

(13 citation statements)

References 31 publications

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“…Based on the criteria of 5 < IOP ≤ 21 mmHg and 20% reduction of preoperative IOP, the complete and quali ed success rates are 47.2% and 77.7% at 3-year follow up. This data is consistent with previous studies in Chinese population [9,10]. There are no signi cant differences in surgical outcomes between PACG and POAG.…”

Section: Discussionsupporting

confidence: 93%

“…The 5-year success rate was 87.3% according to the Japanese Collaborative Bleb-Related Infection Incidence and Treatment Study (CBIITS) [8]. A research in Taiwan described a cumulative quali ed success rate of 67.1% in a 10year follow-up period [9]. A retrospective study on mitomycin C (MMC)-augmented trabeculectomy revealed that the quali ed success rate was 75% after a follow-up period of 21.8 months in Hong Kong [10].…”

Section: Introductionmentioning

confidence: 99%

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Success and Failure Factors for Trabeculectomy in Glaucomatous Patients in Southwest China: A 325 Eyes Analysis

Qin

Qing

et al. 2021

Preprint

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Purpose To evaluate the outcomes and elucidate the success and failure factors for trabeculectomy with mitomycin C (MMC) in Southwest Chinese patients. Methods A retrospective correlational study was conducted on the glaucomatous patients who underwent initial trabeculectomy with MMC in Southwest Hospital and had been followed up for 1-3 years. A complete success for surgery is defined as a postoperative intraocular pressure (IOP) > 5 and ≤ 21 mmHg and 20% reduction of IOP compared to preoperative, without IOP-lowering medications. A qualified success for surgery is defined as the abovementioned postoperative IOP with or without IOP-lowering medications. The primary outcomes were IOP, the number of IOP-lowering medications, and cumulative success rate. The secondary outcomes included best corrected visual acuity (BCVA), mean deviation (MD) of visual field, major complications, and risk factors for surgical failure. Results A total of 325 eyes of 261 glaucomatous patients had been included in our study. Both the mean IOP and the number of IOP-lowering medications were significantly decreased from 32.9 ± 12.0 mmHg to 16.4 ± 5.7 mmHg (P<0.0001) and 3.0 ± 0.9 to 0.9 ± 1.0 (P<0.0001), respectively, at the last visit. The cumulative complete success rate and qualified success rate were 77.8% and 92.0% at 1-year follow-up, and 47.2% and 77.7% at 3-year follow up. There were no significant differences in surgical outcomes between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG). In PACG patients, the success rates of trabeculectomy were comparable with those of phacotrabeculectomy. Hypertension (HR=1.904, P=0.011), encapsulated bleb (HR=2.756, P<0.001), and more preoperative topical medications (HR=2.475, P=0.008) were risk factors for surgical failure. Conclusions The qualified success rate of trabeculectomy with MMC in glaucomatous patients in Southwest China is 92.0% at 1-year follow-up, and 77.7% at 3-year follow up. Hypertension, encapsulated bleb, and more preoperative topical medications are associated with surgical failure.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Success and Failure Factors for Trabeculectomy in Glaucomatous Patients in Southwest China: A 325 Eyes Analysis

Qin

Qing

et al. 2021

Preprint

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“…We found gelatin stent induced pressure reduction over 2 years was generally not influenced by some risk factors recognised to adversely influence trabeculectomy outcomes 3,14,15 . Our results demonstrated no statistically significant effect of ethnicity on gelatin stent survival.…”

Section: Discussionmentioning

confidence: 46%

Outcomes of 45 μm gelatin stent surgery over 24‐month follow‐up

Vukmirovic

Ong

Mukhtar

et al. 2022

Clinical Exper Ophthalmology

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Background:The main objectives of this study were to determine whether known risk factors for trabeculectomy failure similarly influence gelatin stent outcomes and to identify surgical factors which may optimise success.Methods: A retrospective, observational study was conducted at a single centre in Perth, Western Australia over 24 months. Two-hundred and sixty-two eyes of 207 patients underwent XEN-45 stent surgery with various forms of glaucoma.Surgical and postoperative data on subjects undergoing XEN-45 stent surgery was collated. Intraocular pressure (IOP) reduction success was determined using three criteria: 1; IOP <18 mm Hg, 2: IOP <15 mm Hg and 3: >25% IOP reduction from baseline. Kaplan-Meier, mixed effects Cox Proportional hazard model and Chi-Square test were used to measure survival of functioning stents. Results:The success rates at a maximum of 2 years after surgery by criteria 1, 2 and 3 were 61.3%, 26.2% and 28.9% in primary open angle glaucoma (n = 243), 18.8%, 16.9%, 21.4% in angle closure glaucoma (n = 11), 0%, 0%, 66.7% in congenital glaucoma (n = 5) and 0% in uveitic glaucoma (n = 3). No significant reduction in success was found in those eyes that had prior ocular surgery (all p > 0.07).

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“…Landers et al (2012) found that the severity of VF damage, along with higher baseline IOP, previous ocular surgeries and the number of topical medications were risk factors significantly associated with poor surgical outcomes. Chiu et al (2020) recently found that patients with visual acuity less than 6/60 and with a therapy regimen requiring a higher number of glaucoma medications had a higher risk of filtration failure.…”

Section: Stage Of Disease and Visual Impairmentmentioning

confidence: 99%

“…Chiu et al. (2020) recently found that patients with visual acuity less than 6/60 and with a therapy regimen requiring a higher number of glaucoma medications had a higher risk of filtration failure.…”

Section: Factors Affecting the Glaucoma Filtration Surgery Outcomementioning

confidence: 99%

Preparing the ocular surface for glaucoma filtration surgery: an unmet clinical need

Agnifili

Sacchi

Figus

et al. 2022

Acta Ophthalmologica

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The mutual relationship among medical therapy, ocular surface (OS) and filtration surgery (FS) represents one of the most crucial issues in glaucoma management. As the long-term use of intraocular pressure-lowering medications significantly affect the OS health, patients with an uncontrolled disease frequently undergo glaucoma surgery in less-than-ideal conditions. As we known, OS changes strongly affect the post-operative bleb filtration capability. Therefore, improving the OS conditions before proceeding with FS is needed. Currently, given the rapid diffusion of new surgical procedures, this need is even more perceived. Nevertheless, despite surgeons retain the OS preparation of primary importance, and recognize the OS disease (OSD) as the only modifiable risk factor for filtration failure, there is no agreement on which strategies should be preferred to prepare patients. This is largely due to the lack of validated guidelines, which forces clinicians to adopt personal approaches based on evidence derived from low-quality studies. In this review, we provided an overview of risk factors involved in the FS failure, with particular attention to those depending on OS changes, and how OSD negatively affects the aqueous humor resorption after surgery. Moreover, we reported the most exploited measures to mitigate the OSD before surgery, the possible reasons underlying the absence of shared approaches, and the upcoming area of intervention to preserve the OS health during glaucoma management. Finally, based on the current evidence, we proposed a pre-operative outline reporting the main risk factors that should be considered before surgery, and the therapeutical options available to improve the OS.

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Outcomes and risk factors for failure after trabeculectomy in Taiwanese patients: medical chart reviews from 2006 to 2017

Cited by 9 publications

References 31 publications

Success and Failure Factors for Trabeculectomy in Glaucomatous Patients in Southwest China: A 325 Eyes Analysis

Success and Failure Factors for Trabeculectomy in Glaucomatous Patients in Southwest China: A 325 Eyes Analysis

Outcomes of 45 μm gelatin stent surgery over 24‐month follow‐up

Preparing the ocular surface for glaucoma filtration surgery: an unmet clinical need

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