LONG TERM OUTCOMES OF AUGMENTED TRABECULECTOMY WITH 5-FLUOROURACIL IN NIGERIA

Area of Science:

• Ophthalmology
• Surgical Innovation
• Public Health

Background:

• Glaucoma in sub-Saharan Africa is often considered a surgical disease due to challenges with medical treatment accessibility and adherence.
• High intraocular pressure (IOP) is a primary risk factor for glaucoma progression.

Purpose of the Study:

• To evaluate the long-term efficacy and complication rates of trabeculectomy combined with 5-fluorouracil (5-FU) in Nigerian patients.
• To assess the impact of this surgical intervention on intraocular pressure and visual acuity.

Main Methods:

• A retrospective, observational, non-comparative case series design was employed.
• Data from 31 patients (47 eyes) who underwent trabeculectomy with 5-FU at University College Hospital, Ibadan, Nigeria, were analyzed.
• Surgical outcomes were assessed using the World Glaucoma Association consensus criteria, focusing on intraocular pressure (IOP) reduction and complication rates.

Main Results:

• The mean presenting IOP was 31.8±12.2mmHg, significantly reduced to 15.4±4.7mmHg at a mean follow-up of 43 months (P<0.001).
• At three years, 48.5% of patients achieved complete success (IOP ≤21mmHg) without medication, and 90.9% achieved success with or without medication.
• Using a stricter IOP cutoff of ≤15mmHg, 63.6% achieved success at the three-year mark.

Conclusions:

• Trabeculectomy with 5-fluorouracil provides effective long-term IOP reduction in Nigerian glaucoma patients.
• The procedure is associated with minimal complications, making it a valuable surgical option for this population.
• This study supports the role of surgical intervention in managing glaucoma in regions with limited access to medical therapies.