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Reassessing Trabeculectomy: A Long-Term Study with Stringent Success Criteria
Philip Braun1, Daniel Böhringer1, Jens Jordan2
1Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
Journal of Clinical Medicine
|March 28, 2024
Summary
Primary trabeculectomy with mitomycin C (MMC) shows long-term efficacy in lowering intraocular pressure (IOP) for glaucoma patients. However, stricter success criteria revealed lower rates, indicating potential need for further interventions.
Area of Science:
- Ophthalmology
- Surgical Glaucoma Treatment
Background:
- Glaucoma management often requires surgical intervention to lower intraocular pressure (IOP).
- Trabeculectomy with adjunctive mitomycin C (MMC) is a common surgical approach.
Purpose of the Study:
- To evaluate the long-term efficacy and outcomes of primary trabeculectomy with MMC in glaucoma patients.
- To assess success rates based on defined intraocular pressure targets and need for further interventions.
Main Methods:
- Retrospective analysis of 286 eyes undergoing trabeculectomy with MMC (2008-2009).
- Data collection included preoperative and follow-up IOP, glaucoma medications, and subsequent surgical interventions.
- Success criteria: IOP ≤ 15 mmHg without medication, no surgical revision, and no further IOP-lowering surgery.
Main Results:
- Mean follow-up was 5 years (1841 days) with a mean preoperative IOP of 26.1 mmHg.
- Success rates were 25% for IOP ≤ 15 mmHg without medication.
- High success rates (80%) were observed for absence of surgical revision and no need for further glaucoma surgery.
Conclusions:
- Trabeculectomy with MMC can effectively achieve long-term IOP reduction in glaucoma.
- Despite initial success, some patients may require surgical revisions or additional glaucoma surgeries.
- Stricter success criteria in this study may explain lower reported long-term success rates compared to prior research.
