Posters

Intraocular pressure outcomes and risk factors for failure in glaucoma patients without ocular hypertension who were enrolled in the Collaborative Bleb-related Infection Incidence and Treatment Study (CBIITS)

Poster Details

First Author: Y. Murakami JAPAN

Co Author(s):    Y. Kiuchi   Y. Sugimoto   K. Miyoshi              

Abstract Details

Purpose:

To evaluate the efficacy and safety of trabeculectomy for glaucoma patients without ocular hypertension who were enrolled in the Collaborative Bleb-related Infection Incidence and Treatment Study (CBIITS)

Setting:

A total of 295 eyes in 295 patients with glaucoma who had undergone trabeculectomy alone or trabeculectomy combined with phacoemulsification at 34 clinical centers were examined in this study.

Methods:

The enrollment period was 2 years, and follow-up was conducted every 6 months for up to 5 years. Outcomes were measured at 6-month intervals. Two levels of success were defined by achievement of the following intraocular pressure (IOP): (A) The patients that 20% of IOP reduction were obtained, (B) The patients that 30% of IOP reduction were obtained. The primary outcome was the qualified success rate according to the defined criteria. The secondary outcomes included IOP, risk factors for surgical failure, and surgical complications.

Results:

Mean IOP and preoperative antiglaucoma medications were significantly decreased from 16.7_2.7 to 11.6_4.0 mmHg (P < 0.0001) and from 2.7_1.1 to 1.0_1.2 mmHg (P < 0.0001), respectively, 5 years after surgery. For criteria A and B, the qualified success rates were 94.9% and 74.1% at 1 year, respectively, and 87.3% and 42.0% at 5 years, respectively. The third or subsequent trabeculectomy was less effective than the first and second trabeculectomies. The needling procedure and laser suture lysis were associated with the risk of failure. The rates of postoperative hyphema, shallow anterior chamber, bleb leak, and choroidal detachment were 2.3%, 2.0%, 3.4%, and 2.0%, respectively.

Conclusions:

Trabeculectomy with mitomycin C is an effective and safe procedure for reducing IOP in the patients in the CBIITS even if preoperative IOP was low. The number of previous glaucoma surgeries, preoperative IOP, the needling procedure and laser suture lysis after trabeculectomy influenced the success rate, as determined by the target IOP.

Financial Disclosure:

NONE