Topical Brimonidine Is Associated With Trabeculectomy Failure in Glaucoma Patients

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Outcomes

Background:

• Trabeculectomy is a common surgical procedure for glaucoma management.
• The role of preoperative medications in trabeculectomy success is not fully understood.

Purpose of the Study:

• To evaluate the impact of preoperative glaucoma medications on trabeculectomy surgical outcomes.

Main Methods:

• Retrospective observational cohort study of 501 adult glaucoma patients.
• Analysis of preoperative and postoperative electronic medical records up to 3 years.
• Surgical success defined by intraocular pressure (IOP) targets or reduction without reoperation.

Main Results:

• Preoperative brimonidine use was associated with a nearly threefold increased risk of trabeculectomy failure due to high IOP (HR 2.87, p=0.002).
• Higher baseline IOP also predicted failure (HR 1.33, p=0.014).
• No significant impact was observed for other common glaucoma medications, age, gender, race, or glaucoma severity.

Conclusions:

• Brimonidine use before trabeculectomy is linked to significantly higher failure rates.
• Further research is required to elucidate the mechanisms and optimize preoperative medication strategies.