Trabeculectomy: a re-evaluation after three years and a comparison with Scheie's procedure

Area of Science:

• Ophthalmology
• Surgical Techniques
• Glaucoma Management

Background:

• Glaucoma necessitates surgical intervention to manage intraocular pressure (IOP).
• Peripheral iridectomy with thermal sclerostomy and trabeculectomy are surgical options for glaucoma.
• Evaluating surgical success requires assessing both IOP control and visual function.

Purpose of the Study:

• To compare the efficacy and outcomes of the Scheie procedure versus trabeculectomy in glaucoma patients.
• To assess the long-term effects of these surgical techniques on intraocular pressure and visual ability.

Main Methods:

• Seventy-one glaucoma patients underwent either a Scheie procedure or a modified trabeculectomy.
• Surgical success was graded based on achieving the surgeon's target IOP and visual outcomes.
• Patient outcomes were analyzed up to three years post-surgery.

Main Results:

• The Scheie procedure achieved lower mean IOP (12.3 mm Hg) at three years compared to trabeculectomy (16 mm Hg).
• Long-term visual results were comparable between both surgical methods.
• Trabeculectomy was associated with fewer flat anterior chamber complications than the Scheie procedure.

Conclusions:

• The Scheie procedure demonstrates superior IOP lowering capabilities and duration compared to trabeculectomy.
• Trabeculectomy is indicated for specific glaucoma types, including malignant and angle closure glaucoma, but is less effective for secondary glaucoma.
• Both procedures have distinct advantages and disadvantages, requiring careful consideration for optimal patient selection in glaucoma surgery.