Preoperative topical non-steroidal anti-inflammatory drug or steroid and clinical outcomes after trabeculectomy

Autor: Christophe Breusegem, Leegh Spielberg, Ingeborg Stalmans, Thierry Zeyen, Rita Vanginderdeuren
Rok vydání: 2009
Předmět:
Zdroj: Acta Ophthalmologica. 87
ISSN: 1755-3768
1755-375X
DOI: 10.1111/j.1755-3768.2009.3151.x
Popis: Purpose To investigate the benefit of preoperative topical non-steroidal anti-inflammatory drug (NSAID) or steroid after trabeculectomy. Methods In this prospective randomized placebo-controlled trial, 61 patients scheduled for trabeculectomy were randomized to one of 3 study medication groups: NSAID (ketorolac), steroid (fluorometholone) or placebo (artificial tears). Patients instilled one drop 4x daily for 1 month preoperatively and were examined on day 1, 2, at weeks 1, 2, and 4, and at months 3, 6, 12, 18 and 24 following trabeculectomy. Main outcome measures were incidence of postoperative interventions and IOP-lowering medications; complete and qualified success rate; final IOP and relative IOP reduction. Results Fifty-four eyes were entered for analysis. The percentage of patients requiring needling within the first year was 41% in the placebo, 6% in the NSAID and 5% in the steroid group (P = 0.006). The percentage of patients requiring IOP-lowering medication at one year was 24% in the placebo, 18% in the NSAID and 0% in the steroid group (P = 0.054 overall; P = 0.038 for steroids versus others). Log-rank test showed a significant (P = 0.019) difference in medication-free survival curves between the different groups; patients in the steroid group needed significantly less medication (P = 0.007). The inter-group differences in one-year IOP, relative IOP reduction and success rates were not significant. Conclusion Topical ketorolac or fluorometholone for one month preoperatively was associated with improved trabeculectomy outcomes in terms of likelihood of postoperative needling. Within the steroid group, there was a significant reduced need for postoperative IOP-lowering medication.
Databáze: OpenAIRE
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