Trabeculectomy in Eyes With High Myopia

Abstract

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.