Perioperative Complications of Trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS)

Jampel, Henry D.; Musch, David C.; Gillespie, Brenda W.; Lichter, Paul R.; Wright, Martha M.; Guire, Kenneth E.

doi:10.1016/j.ajo.2005.02.013

Cited by 301 publications

(249 citation statements)

References 14 publications

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“…Shallow anterior chamber ranked highest in the list of early post-operative complications and is similar to what had being reported in some other previous studies. 4,12,15,[20][21] There was no clinically documented case of choroidal effusion/detachment, the incidence of which is very low among blacks compared to Caucasians. This study showed no significant correlation between the use of 5-FU and the presence of postoperative shallow anterior chamber.…”

Section: Discussionmentioning

confidence: 99%

“…23 There were much fewer cases of hyphema in this review than reported in some other study in Nigeria 21 and among Caucasians. 15,16 This may be related to the generous but cautious cauterization of the scleral bed at surgery, a technique well favoured by most of the surgeons in the centre. The higher incidence reported among the white subjects in the CIGTS was partly attributed to the fact that perhaps blood was more visible in the eye of whites, and hence a greater reporting.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have reported various types of complications following trabeculectomy with incidence differing from one study to another 4,[12][13][14][15][16] depending on the duration of follow-up, the study population and the surgical techniques such as the use of antimetabolite and releasable sutures. Some of these complications are self-limiting while some adversely affect the overall success of the procedure.…”

Section: Introductionmentioning

confidence: 99%

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Post-operative complication of trabeculectomy in Ibadan, Nigeria: outcome of 1-year follow-up

Ashaye

Komolafe

2007

Eye

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Objective To describe the post-operative complications reported in patients who had trabeculectomy with and without antimetabolite in UCH, Ibadan between 1999 and 2003 and the success rate achieved in term of the post-operative intraocular pressure (IOP). Methods A retrospective study of the records of glaucoma patients who had trabeculectomy between 1999 and 2003 and had follow-up in UCH Ibadan eye clinic for a minimum of 1 year was carried out. Results Seventy-six out of 171 eyes that had trabeculectomy during the period were reviewed. Mean age of patients was 49.4 years. The mean preoperative IOP was 31.8 mm Hg. Success rate of 79.4% was achieved in term of IOP control at a year of follow-up. The most frequent early post-operative complication was shallow AC (13 eyes; 17.1%) while late complication was elevated IOP (21 eyes; 27.6%). Others were encapsulated bleb 7.9% and hyphema 3.9%. There was no significant difference in the complication rate in those who had intraoperative antimetabolite (5-fluorouracil) when compared with those operated without antimetabolite. Conclusion Guarded filtration surgery is effective in controlling IOP. Most of the complications noted were transient and not visually threatening.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Post-operative complication of trabeculectomy in Ibadan, Nigeria: outcome of 1-year follow-up

Ashaye

Komolafe

2007

Eye

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“…[15][16][17] However filtration glaucoma surgery still led to a more intense lowering of the IOP. Zhong et al 14 performed trabeculectomy surgery in a PSS cohort (2 males, 6 females) with uncontrolled IOP (50 ± 5 mm Hg) and visual field defects and stated it as an effective method to decrease IOP to normal level (14 ± 2 mm Hg) without any antiglaucoma medications.…”

Section: Discussionmentioning

confidence: 99%

“…14 Ab interno trabeculectomy (trabectome) can be offered as a minimally invasive device for the surgical treatment of open-angle glaucoma, and as an alternative method for highly complicated and complex open-angle glaucoma surgery. [15][16][17] As the criteria of PSS included an open angle in the gonioscopy, this patient cohort may be suitable for trabectome surgery to decrease the IOP. 3 The aim of the present study was to assess the outcome of trabectome surgery in the treatment of glaucomatocyclitic crisis in patients with uncontrolled IOP.…”

Section: Introductionmentioning

confidence: 99%

Trabeculectomy ab interno (trabectome): yet another possibility in the treatment of uncontrolled glaucomatocyclitic crisis under systemic valganciclovir therapy?

Pahlitzsch

Torun

Gonnermann

et al. 2015

Eye

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Purpose To assess the outcome of trabectome surgery in the treatment of glaucomatocyclitic crisis (Posner-Schlossman syndrome) in patients with uncontrolled intraocular pressure (IOP). Patients/Methods Trabectome surgery was performed in seven patients with diagnosed glaucomatocyclitic crisis and uncontrolled IOP where cytomegalovirus DNA was verified by polymerase chain reaction in aqueous humour samples. All patients were treated with oral valganciclovir. After surgery the patients were followed-up for 12 months. Results Mean IOP before trabectome surgery was 40 ± 10 mm Hg (range 33-58 mm Hg). The mean number of antiglaucoma medication prior to surgery was 3.1 ± 0.4. By the end of the 12 months, IOP in all patients was reduced to normal level (13 ± 1 mm Hg) and their antiglaucoma medication was decreased to 0.8 ± 1.1. No recurring attack of glaucomatocyclitic crisis occurred. Discussion In addition to oral valganciclovir therapy, trabectome surgery seems to be a reliable and effective tool for the management of glaucomatocyclitic crisis with uncontrolled IOP.

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Optimizing Therapy for Newly Diagnosed Open-angle Glaucoma

Pasquale¹

2008

Arch Ophthalmol

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ATIENTS WITH OPEN-ANGLE GLAUCOMA (OAG) would benefit from the safest, most effective approach to preserve their visual function while maximizing their quality of life. Certainly we owe it to our patients to find the best approach to manage glaucoma using evidence-based medicine. The Collaborative Initial Glaucoma Treatment Study (CIGTS) is a randomized clinical trial that tests whether filtration surgery or medical therapy is the best initial step to treat newly diagnosed OAG. Before this study, there were claims that immediate surgery was superior to medical therapy for patients with newly diagnosed OAG (see the study by Musch et al 1 for a list of references). These studies indicated that a surgery-first approach to glaucoma was associated with lower intraocular pressure (IOP), more favorable visual field outcomes, and lower costs than a medicine-first approach. Furthermore, other studies indicated that long-term medical therapy disrupted the integrity of the ocular surface, potentially jeopardizing the success of filtration surgery should it be required if medical therapy failed. Subsequent advances in medical therapy on the one hand and the widespread use of antimetabolites during glaucoma filtration surgery on the other only added complexity to the "incise" vs "instill" debate.

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Perioperative Complications of Trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS)

Cited by 301 publications

References 14 publications

Post-operative complication of trabeculectomy in Ibadan, Nigeria: outcome of 1-year follow-up

Post-operative complication of trabeculectomy in Ibadan, Nigeria: outcome of 1-year follow-up

Trabeculectomy ab interno (trabectome): yet another possibility in the treatment of uncontrolled glaucomatocyclitic crisis under systemic valganciclovir therapy?

Optimizing Therapy for Newly Diagnosed Open-angle Glaucoma

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