Trabeculectomy Outcomes After Glaucoma Drainage Device Surgery
Alizadeh R, Akil H, Tan J, Law SK, Caprioli J J Glaucoma. 2017 Dec 12. [Epub ahead of print]
Study Summary
Trabeculectomy after failed glaucoma drainage device (GDD) is often thought of as a poor choice due to the possibility of violated conjunctiva leading to failure of the trabeculectomy. Thus, no large studies on the success rate of trabeculectomy after GDD have been performed.
This study is one of the first retrospective chart reviews evaluating the outcomes of trabeculectomy with adjunctive mitomycin-C (MMC) in patients with uncontrolled intraocular pressure (IOP) after GDD.
Twenty eyes from 19 patients were included for analysis. Mean IOP (±SD) decreased, from 19.3 ± 4.2 mm Hg prior to surgery to 9.8 ± 2.2 mm Hg at 1 year, 8.8 ± 3.2 mm Hg at 3 years, and 8.4 ± 1.5 mm Hg at 5 years (all P < .001).
The primary outcome was surgical success with stratified IOP targets based on the following criteria: (A) IOP < 18 mm Hg and IOP reduction of 20%; (B) IOP < 15 mm Hg and IOP reduction of 25%; (C) IOP < 12 mm Hg and IOP reduction of 30%. The cumulative success rate between the first to fifth year of follow-up (± SD) for criterion A was 73.2% (± 10.0%) and for criterion B was 68.2% (± 9.5%). Cumulative success for criterion C was 49.1% (± 10.8%) at the first year of follow-up and 32.7% (± 12%) between the second and fifth years of follow-up.
