Clinical observation of trabeculectomy for primary angle closure glaucoma

Abstract

To evaluate the effect of trabeculectomy on intraocular pressure (IOP) and complications in eyes with primary angle closure glaucoma (PACG). It was retrospective clinical study. PACG was classified as acute primary angle closure glaucoma (APACG) group and chronic primary angle closure glaucoma (CPACG) group. APACG was then divided into acute attack phase and chronic phase, and CPACG was divided into chronic phase and late phase. IOP, best corrected visual acuity were compared before and after trabeculectomy in different subgroup of PACG. In addition, the incidence of complications of trabeculectomy was assessed. Statistical analyses were performed using SPSS 12.0 statistics software. Categorical variables such as best corrected visual acuity were compared using nonparametric test, continuous variables such as age and IOP were compared between the two groups using independent two-sample t-tests. Pre- and postoperative IOP were compared using one-way analysis of variance of repeated measures. 40 eyes (37 cases) of APACG and 56 eyes (45 cases) of CPACG were enrolled in this study. The median follow-up period was 24 and 25 months, respectively. IOP was significantly decreased from (53.6 +/- 17.9) mm Hg (1 mm Hg = 0.133 kPa, preoperation) to (10.5 +/- 4.9) mm Hg (postoperation) at time of discharging from hospital and (14.0 +/- 10.3) mm Hg at time of final follow up in APACG (F = 100.783, P < 0.01), respectively, and from (36.8 +/- 13.8) mm Hg to (11.7 +/- 4.2) mm Hg at time of discharging from hospital and (13.8 +/- 4.5) mm Hg at time of final follow up in CPACG (F = 54.383, P < 0.01), respectively. The IOP remained controlled (< or = 21 mm Hg) without antiglaucomatous medication in 38 eyes (95.0%) of APACG and in 50 eyes (89.3%) of CPACG. Visual acuity was significantly (H = 12.316, P < 0.01) decreased after trabeculectomy in all sub-types of PACG by Kruskal-wallis analysis. Shallow anterior chamber was commonly occurred after trabeculectomy. Trabeculectomy is an effective method to control IOP in APACG and CPACG. However, the high proportion of impaired vision was found following trabeculectomy in this study and warranted further clinical investigation.