Filtration surgery in black patients: early results in a West Indian population

We reviewed the early results of 80 filtration procedures when used as the initial surgical treatment in a Saint Lucian West Indian black population with primary open angle glaucoma. Two techniques were used: trabeculectomy under a scleral flap with fornix-based conjunctival flap (Group 1) and full thickness posterior lip sclerectomy with limbal-based conjunctival flap (Group 2). Postoperatively, with an average follow-up of six months, Group 2 had significantly lower intraocular pressures, reduced glaucoma medication requirements, and increased cystic bleb formation. Vision did not differ significantly between the two groups postoperatively, although two Group 1 patients developed progressive glaucomatous visual loss. Complications were slightly more frequent in Group 2. The results of this study suggest that a full thickness sclerectomy technique merits consideration as the initial filtration procedure of choice in West Indian blacks with advanced open angle glaucoma.