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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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Odds ratio of failure and of qualified success, at baseline and follow-up. Data are presented with 95% confidence intervals. (* = p < 0.05, ** = p < 0.001 according to Wald Χ2 test).
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Fig5: Odds ratio of failure and of qualified success, at baseline and follow-up. Data are presented with 95% confidence intervals. (* = p < 0.05, ** = p < 0.001 according to Wald Χ2 test).

Mentions: The odds ratios of failure of trabeculectomy surgery are illustrated in Figure 5. The odds ratio of trabeculectomy failure at 3 years was 0.93 (95% C.I. 0.83-1.03, p = 0.15 Wald Χ2 test) per mmHg pre-operative IOP. The odds ratio did not differ significantly between 6-month,1-year, 2-year and 3-year follow-ups (p > 0.05 at each time-point, Wald Χ2 test). Failure of trabeculectomy surgery within the period of follow-up showed no association with use of mitomycin C (p = 0.369, Fisher’s exact test).Figure 5


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)

Odds ratio of failure and of qualified success, at baseline and follow-up. Data are presented with 95% confidence intervals. (* = p < 0.05, ** = p < 0.001 according to Wald Χ2 test).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig5: Odds ratio of failure and of qualified success, at baseline and follow-up. Data are presented with 95% confidence intervals. (* = p < 0.05, ** = p < 0.001 according to Wald Χ2 test).
Mentions: The odds ratios of failure of trabeculectomy surgery are illustrated in Figure 5. The odds ratio of trabeculectomy failure at 3 years was 0.93 (95% C.I. 0.83-1.03, p = 0.15 Wald Χ2 test) per mmHg pre-operative IOP. The odds ratio did not differ significantly between 6-month,1-year, 2-year and 3-year follow-ups (p > 0.05 at each time-point, Wald Χ2 test). Failure of trabeculectomy surgery within the period of follow-up showed no association with use of mitomycin C (p = 0.369, Fisher’s exact test).Figure 5

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