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Published:
Sep 15, 2005Keywords:
trabeculectomy intraocular oressure 5-fluorouracil sclerectomy
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Comparison of the techniques of Trabeculectomy in intraocular pressure control - a 5 year review
Abstract
Aims and Objectives: To review the effectiveness of the various techniques of trabeculectomy used at the Eye Foundation Hospital Lagos.
Materials and Methods: A retrospective study of all consecutive trabeculectomies done from 1995 to 2000 was carried out. 183 eyes of 130 patients were classified into 4 groups, based on the type of technique used. Group A: Trabeculectomy using a fornix or limbal-based conjuctival flap and scleral flap without 5-fluorouracil (5-FU). Group B: Trabeculectomy with 5-fluorouracil. (5-FU). Group C: Modification of trabeculectomy by triangular sclerectomy from the lateral sides of the scleral flap with 5-FU (modified trabeculectomy with 5-FU). Group D: Modified trabeculectomy without 5-FU. The number of eyes in each group was: Group A - 20, Group B - 113, Group C - 18 and Group D - 32. The information obtained formed the database for analysis using EpiInfo 6.
Main Outcome Measures: Intraocular pressure maintained below 15mmHg is classified as absolute success. Intraocular pressure between 16 and 20mmHg, with or without medication, is classified success, while over 20mmHg is considered as failure. The other outcome measures are mean intraocular pressure and the number of anti-glaucoma drugs used post-operatively.
Results: During the five-year period, the mean intraocular pressure was consistently lowest in group C, followed by group D, group B, and group A, in order of increasing mean intraocular pressure. The mean intraocular pressure was lower than 15mmHg in all the groups at the end of the 5-year period. The number of patients on medication was reduced from 173 preoperative to 42 (0.23%) postoperatively.
Conclusions: Modification of the scleral flap yielded a better intraocular-pressure lowering effect. Long-term drainage was further improved by 5-fluorouracil enhancement.
Key words: trabeculectomy, intraocular oressure, 5-fluorouracil, sclerectomy
Nigerian Journal of Ophthalmology Vol 12(2) 2004: 56-59
Materials and Methods: A retrospective study of all consecutive trabeculectomies done from 1995 to 2000 was carried out. 183 eyes of 130 patients were classified into 4 groups, based on the type of technique used. Group A: Trabeculectomy using a fornix or limbal-based conjuctival flap and scleral flap without 5-fluorouracil (5-FU). Group B: Trabeculectomy with 5-fluorouracil. (5-FU). Group C: Modification of trabeculectomy by triangular sclerectomy from the lateral sides of the scleral flap with 5-FU (modified trabeculectomy with 5-FU). Group D: Modified trabeculectomy without 5-FU. The number of eyes in each group was: Group A - 20, Group B - 113, Group C - 18 and Group D - 32. The information obtained formed the database for analysis using EpiInfo 6.
Main Outcome Measures: Intraocular pressure maintained below 15mmHg is classified as absolute success. Intraocular pressure between 16 and 20mmHg, with or without medication, is classified success, while over 20mmHg is considered as failure. The other outcome measures are mean intraocular pressure and the number of anti-glaucoma drugs used post-operatively.
Results: During the five-year period, the mean intraocular pressure was consistently lowest in group C, followed by group D, group B, and group A, in order of increasing mean intraocular pressure. The mean intraocular pressure was lower than 15mmHg in all the groups at the end of the 5-year period. The number of patients on medication was reduced from 173 preoperative to 42 (0.23%) postoperatively.
Conclusions: Modification of the scleral flap yielded a better intraocular-pressure lowering effect. Long-term drainage was further improved by 5-fluorouracil enhancement.
Key words: trabeculectomy, intraocular oressure, 5-fluorouracil, sclerectomy
Nigerian Journal of Ophthalmology Vol 12(2) 2004: 56-59
