Lower Success in Trabeculectomies in Exfoliation Compared With Primary Open-angle Glaucoma Patients in Sweden.

Abstract

In a Sweden-based study, a lower success rate in exfoliation than in open-angle glaucoma patients was found in a 5-year follow-up after trabeculectomy. The present study aimed to compare the success of trabeculectomies in exfoliation versus open-angle glaucoma patients. Data were gathered through a retrospective chart review. Included patients underwent primary trabeculectomy from January 1 2009 till December 31, 2014 (6 y). All included patients were operated on at the Eye Department, Skaraborg Hospital, Sweden, and followed for at least 5 years after surgery. Included patients had primary open-angle glaucoma (POAG) or exfoliation glaucoma (EXFG). The study followed the recommendations of the World Glaucoma Association (WGA). Successful result: criterion A: eye pressure ≤18 mm Hg and pressure reduction ≥30% without medications (complete success: A1), with or without medications (qualified success: A2). Criterion B: eye pressure ≤15 mm Hg and pressure reduction ≥40% without medications (complete success: B1), with or without medications (qualified success: B2). A total of 147 patients were included in this study, 92 in the EXFG and 55 in the POAG group. At the baseline, only 3 variables (intraocular pressure, number of medications, and the number of laser treatments) showed a significant difference between EXFG and POAG patients. Complete and qualified success for both criterion A (A1 and A2) and B (B1 and B2) were significantly lower in the EXFG compared with the POAG group (Mantel-Cox test, P<0.0001, P=0.01, P<0.001, P=0.008). Trabeculectomies in EXFG seem to have a lower success rate than in POAG patients. EXFG patients should be checked often after trabeculectomy to detect the failure of the surgery.