Trabeculectomy with an active postoperative regimen: results and resource utilization

Abstract

ABSTRACT.Purpose: To evaluate intraocular pressure (IOP) and resource utilization after trabeculectomy, using an active postoperative regimen, in a Swedish population. Methods: A retrospective analysis was performed on the patient charts of all patients who underwent trabeculectomy in a Swedish university hospital during 1 year (November 2000-December 2001. Trabeculectomy was performed in 34 eyes and trabeculectomy in combination with phacoemulsification in 10 eyes. Intraocular pressure, visual acuity, complications and numbers of injections of 5-fluorouracil, suture removal, needling procedures and visits to ophthalmologists were recorded for 2 years. Results: Mean IOP before surgery was 30.4 mmHg (standard deviation [SD] 9.5) in eyes with capsular glaucoma and 28.7 mmHg (SD 9.3) in eyes with primary open-angle glaucoma. Mean IOP after 2 years was 15.3 mmHg (SD 3.9) in all eyes. Intraocular pressure of < 18 mmHg was achieved in 65% of the eyes after 2 years, as was IOP £ 13 mmHg in 37%. Flap or suture manipulation was performed in 41 of 44 eyes. Needling procedures were carried out a mean of 2.3 times in 31 eyes. The mean number of visits to an ophthalmologist was 14.1 during the first postoperative year and 4.4 during the second. Conclusions: The results were encouraging, with few complications and modest resource utilization.

Canaloplasty: Circumferential viscodilation and tensioning of Schlemm canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults

“…The lowest IOP and medication results were usually associated with the use of adjunctive antimetabolites and careful postoperative management of the eye. 6,11,14 The associative analysis of the 2-year results indicate that 36% of eyes with canaloplasty alone and 50% of canaloplasty alone eyes with observed trabecular meshwork distension met the criteria for AGIS associative analysis Group A (no mean 24 compare favorably to those of trabeculectomy. The incidence of hypotony after trabeculectomy is reported to be between 4% and 42%.…”

Canaloplasty: Three-year results of circumferential viscodilation and tensioning of Schlemm canal using a microcatheter to treat open-angle glaucoma

“…Because canaloplasty is not dependent on bleb formation, immediate postoperative care does not entail bleb massage or suture release to enhance flow. In comparison, Taube et al 28 report that the mean number of visits to an ophthalmologist during the first postoperative year was 14.1 G 3.1 per patient, with 93% of patients requiring bleb manipulations. King et al 29 examined the type and frequency of postoperative bleb manipulations after trabeculectomy with intraoperative MMC and found that 93 (78.2%) of 119 trabeculectomies were followed by some form of bleb manipulation.…”

Three-year canaloplasty outcomes for the treatment of open-angle glaucoma: European study results

“…No antimetabolites were used, as they have their own inherent risks. As canaloplasty is not dependent upon external filtration, immediate postoperative care does not necessitate bleb manipulations to enhance flow, such as massage, laser suture lysis, needling, and subconjunctival injections of anti-metabolites, which are often required after trabeculectomy [27].…”