Primary Trabeculectomy Outcomes by Glaucoma Fellows in a Tertiary Hospital in Brazil

Abe, Ricardo Y.; Shigueoka, Leonardo; Vasconcellos, José Paulo Cabral de; Costa, Vital Paulino

doi:10.1097/ijg.0000000000000775

Cited by 10 publications

(7 citation statements)

References 34 publications

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“…On the other hand, there was no statistically significant change in visual acuity of our patients which is in line with other studies reported. 4,9,11 The mean decrease in IOP noted in our study was similar to the results of a study conducted by Shahid et al 4 Similarly, a study conducted in Nigeria also reported a significant reduction in IOP. 12 Even though a higher IOP reduction was reported in our study, setting a target pressure is always individualized according to the patient individual characteristics.…”

Section: Discussionsupporting

confidence: 90%

“…13 We also found a significant reduction in antiglaucoma medications in our patients which was similar to a study conducted in Brazil. 11 Similar drop in the use of antiglaucoma medications was reported in a study conducted in Sweden. 14 New surgical technologies for example shunts, canaloplasty, Trabectome and endoscopic cyclophotocoagulation (ECP), have been developed to provide safe and effective control of intraocular pressure but conventional trabeculectomy has an important role in glaucoma management.…”

Section: Discussionsupporting

confidence: 71%

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Outcomes of Trabeculectomy at a Newly Established Glaucoma Clinic in Khyber Pakhtunkhwa

2021

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Purpose: To determine the outcomes of trabeculectomy in patients with open angle glaucoma at a newly established glaucoma clinic in a tertiary care hospital of Khyber Pakhtunkhwa. Study Design: Retrospective chart review. Place and Duration of Study: Glaucoma Clinic, Hayatabad Medical Complex, Peshawar from May 2018 to December 2019. Methods: A retrospective chart review of patients of 18 years age or above and who underwent trabeculectomy for open angle glaucoma, with at least one follow-up visit were included. Data was collected for age, gender, type of glaucoma, preoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of pre-operative/post-operative topical anti-glaucoma medications, indication for trabeculectomy, preoperative comorbidities and postoperative complications. Data were analyzed using SPSS version 23. The student’s paired t-test was used for comparative analysis of the same group. A p-value of < 0.05 was considered significant. Results: A total of 20 eyes of 20 patients were included in this study, 13 (65%) patients were males, and the mean age was 54.60 ± 18.22 years. There was a statistically significant change in mean IOP postoperatively (35.60 ± 13.28 versus 11.2 ± 6.1, P < 0.001) and number of antiglaucoma medication (2.95 ± 1.19 versus 0.4 ± 0.99, P < 0.001). While there was no significant change in best-corrected visual acuity (1.35 ± 0.88 versus 1.06 ± 0.72, p = 0.36). Conclusion: Trabeculectomy performed at the newly established glaucoma clinic showed a significant reduction in Intraocular pressure without compromising the visual acuity of the study participants. Key Words: Trabeculectomy; Open Angle Glaucoma; Intraocular pressure.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 71%

Outcomes of Trabeculectomy at a Newly Established Glaucoma Clinic in Khyber Pakhtunkhwa

2021

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“…The incidence of complications was 7%, but no bleb-related complication was observed, which was lower than previously reported (refs. [19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Posterior Scleral Application of Mitomycin C-Soaked Sponge in Trabeculectomy

Song

Lin

et al. 2022

Preprint

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Background/Objectives: To evaluate the safety and efficacy of posterior scleral application (a modified technique) of antimetabolite mitomycin C (MMC)-soaked sponge in trabeculectomy for patients with glaucoma. Subjects/Methods: A total of 101 patients (115 eyes) with glaucoma, aged 12–83 years who underwent trabeculectomy using a modified MMC-soaked sponge placement method were enrolled in this observational study. The sponge was placed vertically and posteriorly with the long side perpendicular to the limbus. The MMC concentration was 0.2–0.5 mg/ml and the exposure time was 1–5 min. The intraocular pressure (IOP), best-corrected visual acuity, and the number of hypotensive medications taken at baseline and at the final visit were recorded. Complications, interventions required, and bleb morphology were recorded postoperatively. Bleb morphology, including height, extent, vascularity, Seidel test, and width, was graded using the Indiana Bleb Appearance Grading Scale. The primary outcome was the safety of trabeculectomy including complications and bleb morphology. The secondary outcome was the success rate of trabeculectomy. Results: The median follow-up period was 28 months. At the final follow-up, the qualified (cumulative) success rate was 93.0% and the complete success rate was 60.0%. No bleb-related complication was observed. The mean height was 0.6 ± 0.9. The mean extent was 1.2 ± 0.4. The mean vascularity was 2.4 ± 0.9. All Seidel tests were negative. The mean width was 0.8 ± 0.4. Conclusions: Trabeculectomy with the long side of the MMC-soaked sponge placed perpendicular to the corneal limbus to maximise the exposure area is safe and effective.

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“…All surgeries were performed using standard techniques previously described. 13 Preoperatively and during follow-up, subjects underwent comprehensive ophthalmologic examinations including a review of medical history, visual acuity, slit-lamp biomicroscopy, IOP measurement (Goldmann tonometer), gonioscopy (Possner goniolens), dilated fundoscopic examination with 78 D lens, and optic disc photography. Subjects underwent standard automated perimetry (SAP) using the 24-2 Swedish interactive threshold algorithm (Carl Zeiss Meditec, Inc.) and ocular biometry (IOL Master, Carl Zeiss Meditec, Inc.).…”

Section: Methodsmentioning

confidence: 99%

“…We included all data available until 48 months of follow-up. All surgeries were performed using standard techniques previously described 13 . Preoperatively and during follow-up, subjects underwent comprehensive ophthalmologic examinations including a review of medical history, visual acuity, slit-lamp biomicroscopy, IOP measurement (Goldmann tonometer), gonioscopy (Possner goniolens), dilated fundoscopic examination with 78 D lens, and optic disc photography.…”

Section: Methodsmentioning

confidence: 99%

Trabeculectomy in Eyes With High Myopia

Abe,

Oltramari,

Vessani

et al. 2023

Journal of Glaucoma

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Precis: Primary trabeculectomy was safe and effective at lowering intraocular pressure in patients with primary open angle glaucoma and high myopia. Purpose: To investigate the efficacy and safety of trabeculectomy in patients with glaucoma and high myopia. Patient and Methods: Retrospective case control study. Glaucomatous patients with high myopia undergoing primary trabeculectomy surgery with at least one year of follow-up were compared to an age-matched control group without high myopia undergoing the same procedure. Surgical success was defined as: IOP ≤ 15 mm Hg with (qualified) or without (complete) antiglaucoma medications and at least 20% reduction from baseline IOP at the end of 48 months of follow-up. Results: We included a total of 90 eyes from 90 patients (45 eyes with high myopia and 45 controls). Within the 90 eyes, 70 eyes underwent trabeculectomy and 20 eyes underwent combined phacoemulsification and trabeculectomy. Although patients with high myopia had higher chances for failure (37% vs. 22%) compared to controls, the difference was not statistically significant (P=0.067). In the multivariable analysis, patients with African descent (P=0.043) and those with juvenile glaucoma (P=0.001) had more chances of failure, even after adjusting for myopia. There was no statistically significant difference between complication rates in both groups. Conclusion: Trabeculectomy was effective in reducing IOP in patients with high myopia and glaucoma, without additional risk of complications compared to a control group.

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Primary Trabeculectomy Outcomes by Glaucoma Fellows in a Tertiary Hospital in Brazil

Abstract: A success rate of approximately 60% was obtained 3 years after primary trabeculectomy performed by trainees. Patients with neovascular glaucoma, who underwent suture lysis and who presented an early bleb leak had an increased risk for failure during follow-up.

Cited by 10 publications

References 34 publications

Outcomes of Trabeculectomy at a Newly Established Glaucoma Clinic in Khyber Pakhtunkhwa

Outcomes of Trabeculectomy at a Newly Established Glaucoma Clinic in Khyber Pakhtunkhwa

Safety and Efficacy of Posterior Scleral Application of Mitomycin C-Soaked Sponge in Trabeculectomy

Trabeculectomy in Eyes With High Myopia

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