The Outcomes of Trabeculectomy Surgery among Patients at Makkah Specialist Eye Hospital Bauchi Nigeria

Abstract

Trabeculectomy remains the world’s gold standard and the main therapeutic intervention for controlling moderate to advanced glaucoma in Nigeria due to the expensive anti-glaucoma drugs as well as the unavailability of facilities to carry out minimal invasive glaucoma surgery (MIGS). There is still limited knowledge of the outcome of trabeculectomy surgery in northeastern, Nigeria. To determine the outcomes of trabeculectomy surgery regarding lowering post-operative Intra Ocular Pressure (IOP), preserved visual acuity (VA) as well as a preserved functional vision among glaucoma patients attending Makkah Specialist Eye Hospital Bauchi (MSEHB). A retrospective trabeculectomy surgery data search of operating theatre records was done to collect the outcomes from January 2021 to January 2023. Patients who have undergone trabeculectomy with a minimum follow-up of 6 months were included in the study. The criteria for a good outcome were post-operative IOP of less than 22mmHG or at least 30% reduction from pre-operative levels, and a preserved aided VA. A visiting consultant from the Ophthalmology Department of Federal Teaching Hospital Gombe performed the trabeculectomy surgeries. A total of fifty-two eyes of 50 patients having a postoperative follow-up of six months were included in the study. The mean age at presentation was 54.10(± 13.02) years. On the last day before surgery, the mean Snellen VA was 0.37(± 0.36) but became 0.40(± 0.36) post-operatively, p = 0.01, mean cup-to-disc ratio (CDR) was 0.86(± 0.12) but changed to 0.87(± 0.12) p = 0.79 at six months after surgery. Complete success, qualified success (with postoperative anti-glaucoma eyedrops), and failure of trabeculectomy (even with postoperative anti-glaucoma eyedrops) were 47(90.40%), 4(7.70%), and 1(1.90%), respectively. Based on the IOP, the complete success rate of trabeculectomy was 90.40%. The mean preoperative Snellen VA was improved by about half a line, six months after surgery and there was a significant reduction of IOP from its baseline. These outcomes will revolutionize our approach to the referral of suitable candidates for this surgical procedure as well as assure post-operative reserved vision.