Posterior Surgical Revision of Failed Fornix-based Trabeculectomy
| Autor: | Paul R. Cotran, Doaa H. Sobeih |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Intraocular pressure Visual acuity genetic structures Mitomycin medicine.medical_treatment Visual Acuity Glaucoma Ocular Hypotension Trabeculectomy 03 medical and health sciences 0302 clinical medicine Glaucoma surgery Humans Medicine Hyphema Antihypertensive Agents Intraocular Pressure Aged Retrospective Studies Aged 80 and over Antibiotics Antineoplastic business.industry Fornix Middle Aged medicine.disease eye diseases Surgery Ophthalmology 030221 ophthalmology & optometry Current Procedural Terminology Female sense organs medicine.symptom business Conjunctiva Sclera 030217 neurology & neurosurgery |
| Zdroj: | Journal of Glaucoma. 26:947-953 |
| ISSN: | 1057-0829 |
| Popis: | PURPOSE To evaluate outcomes after revision of failed fornix-based trabeculectomy using a posterior conjunctival incision and mitomycin C. METHODS Cases were identified using Current Procedural Terminology codes. Information from clinical records was analyzed retrospectively. Complete success was defined as intraocular pressure (IOP) ≤16 mm Hg with no glaucoma medications and IOP reduction of >20% from preoperative levels. Qualified success was defined as IOP≤16 with or without medications and IOP reduction of >20%. Secondary outcomes included IOP, number of glaucoma medications used, visual acuity, and complications. RESULTS Sixty eyes of 56 patients underwent surgical revision of failed trabeculectomy. The complete success rate at 1 year was 43.7%, declining to 41.7% at 2 years and all time points up to 5 years; qualified success rates were 68.9% at 1 year and at all subsequent time points. Mean IOP declined from 21.2±7.7 (SD) mm Hg preoperatively to 10.9±4.3 mm Hg at 1 year, to 10.5±3.8 mm Hg at 2 years, and to 9.9±4.6 mm Hg at 3 years. The mean number of glaucoma medications used fell from 2.5±0.5 preoperatively to 1.0±0.4 at 1 year, 0.9±0.4 at 2 years, and 0.9±0.4 at 3 years. Complications included bleb leak in 3 eyes (5.0%), hypotony with choroidal detachment in 3 eyes (5.0%) and hyphema in 1 eye (1.7%). Eight eyes required additional glaucoma surgery. CONCLUSIONS Surgical bleb revision with mitomycin C using a posterior incision in cases of failed fornix-based trabeculectomy can provide effective control of IOP. This conjunctiva-sparing procedure should be considered as a viable alternative to a tube shunt or repeat trabeculectomy. |
| Databáze: | OpenAIRE |
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