Posters

Hooding of the flap-modified Cairn's trabeculectomy: a new approach for resilient POAG in Nigeria

Poster Details

First Author: P.Kagathra INDIA

Co Author(s):    O. Aribaba   K. Alabi                 

Abstract Details

Purpose:

Late presentation of patients with advanced POAG with Optic neuropathy is not uncommon in Nigeria. Medical therapy fails in many patients due to late presentation,polypharmacy, poor compliance and ultimately high rate of failed therapy. Success rate of Trabeculectomy in POAG is not as high as we see in Asian population. The suitability of the time tested , safe and modified Cairn's Trabeculectomy is a win win option for such ambivalent scenario which can't be underestimated. The purpose of this study is to assess the surgical efficacy and pressure lowering effect of Modified Cairn's Trabeculectomy at an Eye Hospital , Lagos.

Setting:

Mecure Eye Center, Oshodi, Lagos, Nigeria

Methods:

Retrospective cross sectional single centric descriptive study done.Data of all patients that underwent Trabeculectomy surgery for OAG were retrieved.The method was large tenectomy,MMC on flap and surrounding sclera for 2 minutes,large internal window of 1 by 3mm,Iridectomy and hooding of flap by stitching almost 1.5 mm inside the external end on both side of flap. 86 eyes were operated.Preprocedure pressure and vision was recorded.Postprocedural IOP were measured at 3,6,9 and 12 months and vision at 12 months was recorded.The data was analysed using Graphpad instat software ,Sandiagio,California;Continuous data analysis was done by using ANOVA test;p value <0.05 was considered significant

Results:

Mean age was 59.3 years +-14.8 years. M/F ratio was 2.4 :1.The vision of 6/60 and below was seen in 52 eyes. Mean IOP in all 86 eyes preoperatively was 32.26 +-11.6 & at visit after 3, 6, 9and 12 months it was 16.17 +-5.4, 16.24 +- 5.5, 16.57 +- 5.8, & 16.83 +-5.80 respectively. RE preoperative mean IOP was 31.61 +- 12.31 and in LE 31.98 +- 11.18 . In RE at the end of 1 year had a mean pressure of 17.66 +- 6.81 and in LE 16.13 +- 4.76

Conclusions:

Complete success was seen in 46 eyes , Qualified success ( with Drops ) in 38 eyes and failure in 2 eyes. Statistically decreased pressure after surgery when compared with baseline IOP was significant with p value <0.05. The vision improved in 32 eyes, decreased in 16 eyes , and remained same in 38 eyes ( 14 cases had phaco done ) . The results were significant with acceptable success rate at the end of 1 year in terms of pressure lowering efficacy of this novel method

Financial Disclosure:

None