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Pre-operative intraocular pressure does not influence outcome of trabeculectomy surgery: a retrospective cohort study.

Nesaratnam N, Sarkies N, Martin KR, Shahid H - BMC Ophthalmol (2015)

Bottom Line: Qualified success was defined as surgical success with the use of supplemental medical therapy.Secondary outcomes included visual acuity, Humphrey visual field MD, surgical complications and post-operative interventions.The incidence of surgical complications and post-operative interventions shows no association with pre-operative IOP.

View Article: PubMed Central - PubMed

Affiliation: School of Clinical Medicine, University of Cambridge, Hills Road, Cambridge, CB2 0QQ, UK. nn252@cam.ac.uk.

ABSTRACT

Background: To investigate whether pre-operative intraocular pressure (IOP) predicts outcome of trabeculectomy surgery in patients with primary open angle glaucoma over a 3-year period of follow-up.

Methods: Retrospective cohort study, of a total of 61 patients (80 procedures) who had undergone trabeculectomy surgery after failed medical management at a single centre between 2000 and 2011. Patients were identified through surgical logbooks. A subsequent case note-review identified 61 patients (80 procedures) with primary open angle glaucoma (POAG). The primary outcome was success of trabeculectomy surgery, with failure defined as intraocular pressure (IOP) > 21 mmHg, ≤ 5 mmHg or not reduced by 20% at two consecutive follow-up visits 3-months post-operatively. Qualified success was defined as surgical success with the use of supplemental medical therapy. Secondary outcomes included visual acuity, Humphrey visual field MD, surgical complications and post-operative interventions.

Results: At 3 years, the odds ratio of failure was 0.93 per mmHg pre-operative IOP (95% C.I. 0.83-1.03, p = 0.15 Wald Χ (2) test), and the odds ratio of failure or qualified success was 0.96 (95% C.I. 0.89-1.04, p = 0.35). The incidence of surgical complications showed an odds ratio of 1.02 per mmHg pre-operative IOP (95% C.I. 0.95-1.10, p = 0.55 Wald Χ (2) test). The incidence of post-operative interventions showed an odds ratio of 1.01 per mmHg pre-operative IOP (95% C.I. 0.94-1.09, p = 0.80 Wald Χ (2) test).

Conclusions: Pre-operative IOP does not predict success of trabeculectomy surgery in POAG patients during the first 3 years of follow-up. The incidence of surgical complications and post-operative interventions shows no association with pre-operative IOP.

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Related in: MedlinePlus

Distribution of Intraocular Pressure (IOP), at baseline and follow-up. Baseline IOP for each patient calculated from average of two pre-operative intraocular pressure readings. Mean of these individual readings used as Baseline IOP. Data are presented as mean ± standard error of the mean.
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Fig1: Distribution of Intraocular Pressure (IOP), at baseline and follow-up. Baseline IOP for each patient calculated from average of two pre-operative intraocular pressure readings. Mean of these individual readings used as Baseline IOP. Data are presented as mean ± standard error of the mean.

Mentions: The mean baseline and follow-up IOP measurements for the study patients are shown in Table 2, and illustrated in Figure 1. Thirty eyes included in the study had an intraocular pressure (IOP) consistently less than or equal to 21 mmHg at all clinic visits since diagnosis.Table 2


Pre-operative intraocular pressure does not influence outcome of trabeculectomy surgery: a retrospective cohort study.

Nesaratnam N, Sarkies N, Martin KR, Shahid H - BMC Ophthalmol (2015)

Distribution of Intraocular Pressure (IOP), at baseline and follow-up. Baseline IOP for each patient calculated from average of two pre-operative intraocular pressure readings. Mean of these individual readings used as Baseline IOP. Data are presented as mean ± standard error of the mean.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4352261&req=5

Fig1: Distribution of Intraocular Pressure (IOP), at baseline and follow-up. Baseline IOP for each patient calculated from average of two pre-operative intraocular pressure readings. Mean of these individual readings used as Baseline IOP. Data are presented as mean ± standard error of the mean.
Mentions: The mean baseline and follow-up IOP measurements for the study patients are shown in Table 2, and illustrated in Figure 1. Thirty eyes included in the study had an intraocular pressure (IOP) consistently less than or equal to 21 mmHg at all clinic visits since diagnosis.Table 2

Bottom Line: Qualified success was defined as surgical success with the use of supplemental medical therapy.Secondary outcomes included visual acuity, Humphrey visual field MD, surgical complications and post-operative interventions.The incidence of surgical complications and post-operative interventions shows no association with pre-operative IOP.

View Article: PubMed Central - PubMed

Affiliation: School of Clinical Medicine, University of Cambridge, Hills Road, Cambridge, CB2 0QQ, UK. nn252@cam.ac.uk.

ABSTRACT

Background: To investigate whether pre-operative intraocular pressure (IOP) predicts outcome of trabeculectomy surgery in patients with primary open angle glaucoma over a 3-year period of follow-up.

Methods: Retrospective cohort study, of a total of 61 patients (80 procedures) who had undergone trabeculectomy surgery after failed medical management at a single centre between 2000 and 2011. Patients were identified through surgical logbooks. A subsequent case note-review identified 61 patients (80 procedures) with primary open angle glaucoma (POAG). The primary outcome was success of trabeculectomy surgery, with failure defined as intraocular pressure (IOP) > 21 mmHg, ≤ 5 mmHg or not reduced by 20% at two consecutive follow-up visits 3-months post-operatively. Qualified success was defined as surgical success with the use of supplemental medical therapy. Secondary outcomes included visual acuity, Humphrey visual field MD, surgical complications and post-operative interventions.

Results: At 3 years, the odds ratio of failure was 0.93 per mmHg pre-operative IOP (95% C.I. 0.83-1.03, p = 0.15 Wald Χ (2) test), and the odds ratio of failure or qualified success was 0.96 (95% C.I. 0.89-1.04, p = 0.35). The incidence of surgical complications showed an odds ratio of 1.02 per mmHg pre-operative IOP (95% C.I. 0.95-1.10, p = 0.55 Wald Χ (2) test). The incidence of post-operative interventions showed an odds ratio of 1.01 per mmHg pre-operative IOP (95% C.I. 0.94-1.09, p = 0.80 Wald Χ (2) test).

Conclusions: Pre-operative IOP does not predict success of trabeculectomy surgery in POAG patients during the first 3 years of follow-up. The incidence of surgical complications and post-operative interventions shows no association with pre-operative IOP.

Show MeSH
Related in: MedlinePlus