Audit of Trabeculectomy at a Tertiary Referral Hospital in East Africa
| Autor: | Richard Bowman, Joy Kabiru, Mark E. Wood, Milka Mafwiri |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Intraocular pressure genetic structures Antimetabolites medicine.medical_treatment Visual Acuity Glaucoma Trabeculectomy Tertiary referral hospital Tanzania Postoperative Complications Trabecular Meshwork medicine Glaucoma surgery East africa Humans Referral and Consultation Antihypertensive Agents Intraocular Pressure Aged Retrospective Studies Aged 80 and over Medical Audit business.industry Significant difference Retrospective cohort study Middle Aged medicine.disease Surgery Ophthalmology Optometry Female Fluorouracil business |
| Zdroj: | Journal of Glaucoma. 14:432-434 |
| ISSN: | 1057-0829 |
| DOI: | 10.1097/01.ijg.0000185617.98915.36 |
| Popis: | Aim To audit medium-term results of trabeculectomy at a tertiary referral unit in east Africa. Methods A retrospective review of the files of all patients who underwent trabeculectomy surgery at our hospital during the year 2001. Results One hundred fifty-seven patients were included. Mean age was 61 years (SD = 12). Thirty-one patients (20%) were women; 120 of 145 (83%) eyes had cup/disc ratios of 0.8 or greater preoperatively. Intraoperative 5-fluorouracil (5FU) was used in 57 cases (36%). Mean follow-up was 8 months (0-28, SD = 7). Mean intraocular pressures (IOP) was 25 mm Hg (6-70, SD = 10) preoperatively, 11 mm Hg (0-32, SD = 5) at 2 weeks postoperatively, and 13 mm Hg (0-42, SD = 6) at latest follow-up. One hundred fifteen patients (73%) had intraocular pressure of 15 mm Hg or less at latest follow-up and 141 (90%) had intraocular pressure of 21 mm Hg or less. Twenty (13%) had restarted antiglaucoma medication during the follow-up period. Thirty-seven of 148 (25%) lost 2 lines of Snellen acuity or equivalent between preoperative measurement and latest follow-up. Early postoperative complications (usually leaking bleb or shallow anterior chamber with hypotony) occurred in 18 patients (12%) and this was associated with postoperative loss of 2 or more lines of Snellen acuity (OR = 1.11 95% CI 1.02-1.22, P= 0.02). Patients having had 5FU had lower (t = 3.11, P= 0.02) mean intraocular pressure at 2-month follow-up (12 mm Hg, SD = 5) than those who did not receive it (16 mm Hg, SD = 6) but there was no significant difference at later follow-ups. Men (mean 14 mm Hg, SD = 6) had higher (t = 2.71, P= 0.01) intraocular pressures at latest follow-up than women (mean 11 mm Hg, SD = 3). Conclusions The results of surgery compare well with other reported series. 5FU did not demonstrate significant benefit in terms of intraocular pressure lowering beyond 2 months postoperatively. Early postoperative hypotony should be avoided. The gender difference in intraocular pressure results has not previously been reported and deserves further investigation. |
| Databáze: | OpenAIRE |
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