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Related Experiment Videos

Trabeculectomy at the inferior limbus

R M Caronia1, J M Liebmann, R Friedman

  • 1Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, USA.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|April 1, 1996
PubMed
Summary

Trabeculectomy at the inferior limbus can control intraocular pressure in high-risk glaucoma patients but has a higher risk of late complications. This glaucoma surgery should be reserved for limited therapeutic options.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Ocular Oncology

Background:

  • Trabeculectomy is a common glaucoma surgery to reduce intraocular pressure (IOP).
  • Inferior limbus trabeculectomy is an alternative approach for specific patient populations.
  • Previous intraocular surgery at the superior limbus may impact the success of subsequent glaucoma procedures.

Purpose of the Study:

  • To evaluate the efficacy of inferior limbus trabeculectomy in controlling IOP.
  • To assess surgical complications associated with 5-fluorouracil (5-FU) or mitomycin use in this procedure.
  • To determine the long-term success rates of trabeculectomy at the inferior limbus.

Main Methods:

  • Retrospective chart review of 101 eyes undergoing inferior limbus trabeculectomy between July 1984 and March 1993.

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  • All patients had prior intraocular surgery at the superior limbus.
  • Surgical success defined as IOP between 4-22 mm Hg with at least a 20% reduction from baseline.

    • Main Results:

    • Cumulative surgical success at 2 and 5 years was 56% and 38%, respectively.
    • Medication-free IOP control was achieved in 39% of eyes at 2 years and 15% at 5 years.
    • Complications included 5-FU epitheliopathy (34%), early wound leak (26.7%), choroidal effusion (25.7%), late bleb leak (12.9%), and endophthalmitis (11.9%).

    Conclusions:

    • Inferior limbus trabeculectomy can be successful in high-risk glaucoma patients previously treated with superior limbus surgery.
    • The procedure is associated with a significant risk of late complications, including bleb leaks and endophthalmitis.
    • This surgical approach should be reserved for cases with limited alternative therapeutic options due to its complication profile.