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Post-traumatic angle recession glaucoma: a risk factor for bleb failure after trabeculectomy
A Mermoud1, J F Salmon, C Straker
1Department of Ophthalmology, Groote Schuur Hospital, South Africa.
The British Journal of Ophthalmology
|October 1, 1993
Summary
Post-traumatic angle recession glaucoma significantly worsens trabeculectomy success compared to primary open angle glaucoma. This indicates angle recession is a risk factor for glaucoma surgery failure.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Outcomes
Background:
- Glaucoma filtering surgery, such as trabeculectomy, is a common treatment for glaucoma.
- Post-traumatic angle recession glaucoma is a specific type of glaucoma resulting from eye injury.
- The impact of angle recession on glaucoma surgery outcomes requires further investigation.
Purpose of the Study:
- To determine if post-traumatic angle recession is an independent risk factor for trabeculectomy failure.
- To compare the long-term success rates of trabeculectomy in patients with angle recession glaucoma versus primary open angle glaucoma.
Main Methods:
- A comparative study involving 35 patients with angle recession glaucoma and 35 matched patients with primary open angle glaucoma.
- Trabeculectomy was performed on all participants.
- Surgical success was defined as postoperative intraocular pressure <= 21 mm Hg (with or without medication).
- Kaplan-Meier survival analysis was used to assess long-term outcomes and bleb failure rates.
Main Results:
- Trabeculectomy success was lower in angle recession glaucoma (43%) compared to primary open angle glaucoma (74%).
- Bleb failure occurred significantly earlier in angle recession glaucoma (mean 3.1 months) than in primary open angle glaucoma (mean 9.4 months).
- Kaplan-Meier survival analysis revealed significantly worse long-term success for trabeculectomy in angle recession glaucoma.
Conclusions:
- Post-traumatic angle recession is a significant risk factor for trabeculectomy failure, independent of age or race.
- The findings support the use of antimetabolite therapy to reduce fibrosis and improve outcomes after trabeculectomy in patients with angle recession glaucoma.