Modern Trabeculectomy: Technique, and results from a UK muticentre study

Abstract

AbstractEfficacy and safety of current trabeculectomy surgery Methods: 428 patients with OAG and no previous glaucoma surgery from 9 units were evaluated. All cases had 2 yr minimum follow up. Main outcomes: IOP, VA, complications and interventions. Reoperation for glaucoma (except needling and resuturing) and loss of light perception were classified as failures. Results: Antifibrotics were used in 400 (93%) cases; MMC in 271 (63%), 129 had 5‐FU (30%). At 2 years, IOP (mean ± SD) was 12.3 ± 4.3 mmHg, 370 (86%) had IOP ≤21 mmHg without medication; 405 (95%) achieved an IOP ≤ 21 mmHg overall. IOP ≤18 mm Hg was achieved by 352 (82%) without treatment and 373 (87%) overall. By TVT criteria: 310/365 (85%) had complete success at 2 yr and 335/365 (92%) achieved qualified success. Postoperative treatments: suture manipulation 43%, resuturing 5.1%, bleb needling 16%, postop 5FU 27% and cataract extraction in 31%. Visual loss of more than two lines occurred in 24 (5.6%). 31 (7.2%) had late hypotony (IOP <6 mmHg). 2 patients (0.5%) developed blebitis. One patient had endophthalmitis at 3 wks (0.2%). We show good trabeculectomy outcomes with low rates of complications can be achieved but intensive postoperative care is required.