Predictive value of early IOP in mitomycin-C augmented trabeculectomy

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Outcomes

Background:

• Trabeculectomy with mitomycin-C (MMC) augmentation is a common glaucoma surgery.
• Predicting long-term intraocular pressure (IOP) control after surgery is crucial for patient management.
• Early postoperative IOP is a potential indicator of surgical success.

Purpose of the Study:

• To evaluate if early intraocular pressure (IOP) measurements after MMC-augmented trabeculectomy can predict intermediate-term IOP outcomes.
• To identify early postoperative IOP as a predictive factor for successful glaucoma management.

Main Methods:

• Retrospective review of 92 patients undergoing MMC-augmented trabeculectomy with at least one year of follow-up.
• Exclusion of cases with early bleb leaks.
• Correlation of early IOP measurements (day 1, day 7, month 1) with final IOP at 1 year or last follow-up.

Main Results:

• Patients achieving target IOP (< or =16 mm Hg) at final follow-up had significantly lower mean day 1 IOP (12.5 mm Hg) compared to those with higher final IOP (17.4 mm Hg, P=0.02).
• One-month IOP was a strong predictor: lowest quartile IOP at 1 month was associated with a 14-fold increased likelihood of achieving target IOP without treatment compared to the highest quartile (P<0.001).

Conclusions:

• Early postoperative IOP measurements following MMC-augmented trabeculectomy are valuable predictors of intermediate-term IOP control.
• A low early IOP is a significant positive prognostic indicator for successful glaucoma management after this surgical procedure.