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Outcome of trabeculectomies without adjunctive antimetabolites
Abstract
Objective: To report on the outcome of trabeculectomy without adjunctive antimetabolites in controlling the intraocular pressures of eyes with Primary Open Angle and Normal Tension Glaucomas.
Design: Retrospective, non-comparative interventional case study.
Method:Records of 191 eyes of 164 patients who had undergone standard trabeculectomy were retrospectively analyzed.
Outcome Measure: Successful intraocular pressure control defined as IOP less than 22 mmHg or a reduction of 30% if pre-operative pressure was already less than 22mmHg.
Results: There were 185 (96.8%) eyes with Primary Open Angle glaucoma and 6 (3.2%) with the Normal Tension variant. Mean age of patients was 50.6 years (Range 17-85) with 22% aged below 40 years. There was a statistically significant difference between the mean pre-op and post-op intraocular pressures (38.09, SD=6.11 versus18.97, SD=7.28 mmHg respectively); p=0.0001. The procedure was effective in controlling the intraocular pressures to below 22mmHg in 88.46% and below 18mmHg in 67.95% of OAG eyes at six months. In eyes with NTG only one out of six (16.7%) achieved a successful 30% target pressure reduction.
Conclusion: Trabeculectomy alone was effective in controlling IOPs to less than 22 mmHg in POAG. Lower IOP levels needed to control progressive visual field loss may require the use antimetabolites.
Keywords: intraocular pressure, target pressure, open angle glaucoma, normal tension glaucoma, applanation tonometry
Ghana Medical Journal Vol. 40(2) 2006: 39-44
