Treatment Outcomes of Trabeculectomy in secondary glaucoma at Khonkaen hospital
Abstract
Background : Secondary glaucoma is usually difficult to treat. Poor visual prognosis is depending on glaucoma caused.
Objective: To review causes, success rate and treatment outcomes of trabeculectomy with mitomycin-C in secondary glaucoma at Khonkaen hospital.
Material and Method: A descriptive retrospective study of all secondary glaucoma patients and underwent trabeculectomy with mitomycin-C between January 2013 and April 2017. The primary outcome measures were post trabeculectomy intraocular pressure, numbers of anti-glaucoma medications, success rate and failure rate. The secondary outcome measures were complications and additional glaucoma surgery.
Result: One hundred and forty eyes underwent trabeculectomy. Most frequent types were POAG 65 eyes (46.43%), CACG 40 eyes (28.57%) and secondary glaucoma 35 eyes (25.0%). Thirty-five eyes of secondary glaucoma were reviewed. The most common etiology of secondary glaucoma was uveitis glaucoma (45.71%) followed by neovascular glaucoma (31.43%), steroid induced glaucoma (8.57%), traumatic glaucoma (5.71%), pseudoexfoliation glaucoma (2.86%), pigment dispersion glaucoma (2.86%) and post penetrating keratoplasty (2.86%). Mean preoperative intraocular pressure was 34.77±11.91 mm.Hg. and at final visit was 14.40 ±5.70 mm.Hg.(p=0.000). Mean follow-up was 15.83±10.78 months. Complete success was 54.29%. Visual acuity was improved, remained stable and worse in 37.14%, 31.43% and 28.57%, respectively. Post operative hyphema, hypotony and flat anterior chamber were found but no evidence of endophthalmitis.
Conclusion: Trabeculectomy with mitomycin-C is effective for controlled intraocular pressure in most cases of secondary glaucoma and reducing number of medications and help save costs for long term treatment. Disease underlying treatment and control prior to surgery provide higher chance in successful IOP.
Keywords: Secondary glaucoma, Trabeculectomy with mitomycin-C, Glaucoma filtering surgery
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