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Relationship between age and surgical success after trabeculectomy with adjunctive mitomycin C
Thi Kieu Hau Hoang1,2, Young Kook Kim1, Jin Wook Jeoung1
1Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Purpose:
To investigate whether there is any effect of age on bleb morphology and surgical success after trabeculectomy with adjunctive Mitomycin C (MMC).
Methods:
A total 143 eyes of 123 patients were divided into two groups: group 1 ( ≤ 60 years old, n = 85) and group 2 ( > 60 years old, n = 58). Kaplan-Meier survival curve analysis was used to assess long-term surgical success according to "complete success" (intraocular pressure (IOP) reduction ≥ 30% without medications) and "qualified success" criteria (IOP reduction ≥ 30%, with or without medications) between the two groups. Cox proportional hazard models were used to examine the factors associated with surgical success. Bleb morphology was evaluated by height, extent and vascularity at postoperative 1 month, 3 months, 6 months, and 12 months.
Results:
The younger-age group (group 1) showed significantly better results, in terms of both complete success and qualified success, than did the older-age group (group 2) (p < 0.001 and p = 0.01, respectively). Age and preoperative anti-glaucoma medications were the factors related to complete success (p = 0.001). Also, there were significant differences in height, extent and vascularity of bleb between the two groups (p = 0.038, p = 0.002 and p = 0.006, respectively).
Conclusion:
The long-term surgical outcome after trabeculectomy with MMC was better in the younger-age group than in the older-age group. Specifically, the younger-age group showed a more prominent and more localized bleb with less vascularity.
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