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Outcome of consecutive trabeculectomy
Miriam Zalish1, Yoram Oron, Orna Geyer
1Department of Ophthalmology, Kaplan Medical Center, Rehovot, and Hebrew University-Hadassah Medical School, Jerusalem, Israel. zalishm@yahoo.com
Clinical & Experimental Ophthalmology
|January 30, 2004
Summary
The surgical outcome of trabeculectomy in one eye can predict the success in the fellow eye for glaucoma patients. This finding holds true whether or not antimetabolites were used during the procedure.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Outcomes
Background:
- Trabeculectomy is a common surgical procedure for glaucoma management.
- Predicting surgical success in the second eye can aid in patient counseling and management.
- The use of antimetabolites can influence trabeculectomy outcomes.
Purpose of the Study:
- To determine if the outcome of primary phakic trabeculectomy in the first eye can predict the surgical success in the second eye of the same patient.
- To establish a criterion for success in bilateral trabeculectomy cases.
Main Methods:
- Retrospective comparison of primary phakic trabeculectomy outcomes in both eyes of 23 patients.
- Patients were divided into two groups: those treated with antimetabolites (16) and those not (7).
- Postoperative intraocular pressure (IOP) and glaucoma medication use were compared between paired eyes. Surgical success was defined as IOP < 20 mmHg without medication.
Main Results:
- A positive correlation was observed in IOP values between paired eyes across both groups.
- The number of glaucoma medications used post-surgery did not significantly differ between paired eyes.
- Surgical failure was more frequent in paired eyes, with bilateral failure occurring in 60% of antimetabolite-treated and 100% of untreated failed cases.
Conclusions:
- Trabeculectomy outcomes were similar in both antimetabolite-treated and untreated eyes.
- The surgical result in the first operated eye can reliably predict the outcome in the second operated eye.
- This predictability can inform surgical planning and patient expectations for bilateral glaucoma surgery.
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