Evaluation of ocular surface disease in patients after trabeculectomy: comparative study with and without intracameral bevacizumab in a district hospital

Session Details

Session Title: Quality of Vision and Dry Eye

Session Date/Time: Sunday 08/10/2017 | 08:00-09:30

Paper Time: 08:06

Venue: Room 3.4

First Author: : S.Parreira PORTUGAL

Co Author(s): :    S. Barros   A. Miranda   D. Lopes   N. Marques   P. Telles   N. Campos     

Abstract Details

Purpose:

Ocular surface disease (OSD) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface. Trabeculectomy remains the first-line surgical treatment for glaucoma and although the success rate has significantly improved with the adjunctive antimetabolites treatment, complications such as OSD may compromise visual function postoperatively. Our aim was to compare clinical signs of OSD in patients who had undergone trabeculectomy with and without bevacizumab.

Setting:

Department of Ophthalmology, Hospital Garcia de Orta EPE, Almada, Portugal

Methods:

This was a cross-sectional, case-comparison study that includes 21 patients and 41 eyes: 21 eyes underwent simple trabeculectomy (Group 1), 9 eyes underwent trabeculectomy with intracameral bevacizumab (Group 2) and 11 eyes that did not undergo surgery (fellow eyes). All patients completed the Ocular Surface Disease Index (OSDI) questionnaire to assess symptoms and total OSDI scores (0-100) were calculated for each patient. Evaluation of fluorescein corneal staining (score between 0-3) and a Schirmer tear test were executed for every patient.

Results:

The parameters of Group 1 and 2 were compared using the Mann-Whitney U test. There were no significant differences in the corneal staining score (P=0.422), Schirmer’s test results (P=0.326) and OSDI scores (P=0.053) between these groups. The fellow eyes were compared with operated eyes using the Wilcoxon test. The corneal staining score was greater in operated eyes than in non-operated eyes (1.27 vs 0.64; P=0.02). Eyes did not undergo surgery had significantly higher Schirmer’s results than eyes with trabeculectomy (22.00 vs 15.27; P=0.005).

Conclusions:

OSD is a clinical problem often overlooked in patients who undergo filtration surgery and recognition of the condition and appropriate treatment can improve patient symptoms. The results of this study suggested that the use of intracameral bevacizumab could be a safe and a possible adjunctive treatment without increasing complications when compared with simple trabeculectomy. Due to our small sample size, which limits the statistical comparison between the groups, further larger randomized trials are required to investigate the long term results.

Financial Disclosure:

NONE