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Long-term intraocular pressure control by trabeculectomy: a ten-year life table
D I Robinson1, S Lertsumitkul, F A Billson
1Sydney Eye Hospital, Sir John Young Crescent, Woolloomooloo, NSW.
Summary
Trabeculectomy success rates for glaucoma control were 78% at two years and 67% at 10 years. Antiglaucoma medication significantly improved long-term intraocular pressure control and survival outcomes.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Outcomes
Background:
- Trabeculectomy is a common surgical procedure for glaucoma management.
- Long-term efficacy and factors influencing success require ongoing investigation.
Purpose of the Study:
- To evaluate the long-term success rates of trabeculectomy.
- To identify factors affecting surgical outcomes in glaucoma patients.
Main Methods:
- Retrospective analysis of 179 eyes from 127 patients undergoing trabeculectomy (1977-1982).
- Life table method used for survival analysis.
- Evaluation of intraocular pressure (IOP) control and medication use.
Main Results:
- Cumulative two, five, and 10-year success rates were 78%, 70%, and 67% respectively.
- Mean IOP control duration was 88 months.
- Antiglaucoma medication significantly improved long-term survival (HR 0.49, P=0.01).
- Success rates with medication use reached 89% (2-year), 87% (5-year), and 86% (10-year).
- A transient IOP rise was observed between 2 weeks and 3 months post-surgery.
- Topical steroid use showed a suggestive but not conclusive improvement in success rates (HR 0.69, P=0.21).
- No significant difference in survival between fornix and limbal-based flap techniques.
Conclusions:
- Trabeculectomy demonstrates moderate long-term success in glaucoma management.
- Adjunctive antiglaucoma medication is crucial for enhancing long-term surgical success and IOP control.
- Surgical technique (fornix vs. limbal flap) did not impact survival rates.