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CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2021; 13(03): 122-126
DOI: 10.4103/ijmbs.ijmbs_144_20
Original Article

Short-term outcomes of trabeculectomy surgery in primary open-angle glaucoma

Samar Bukhatwa
Department of Ophthalmology, Faculty of Medicine, University of Benghazi, Benghazi, Libya
,
El-Said Metmoah
Department of Ophthalmology, Faculty of Medicine, University of Benghazi, Benghazi, Libya
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Introduction: Trabeculectomy controls the intraocular pressure (IOP) and decreases the progress of open-angle glaucoma; the outcome of such procedure has not been ascertained in Libya. Objective: We report the short-term outcome of trabeculectomy in terms of IOP in primary open-angle glaucoma (POAG). Settings and Design: The medical records of the trabeculectomy patients previously diagnosed with POAG were reviewed retrospectively. Patients and Methods: Case characteristics were extracted including preoperative IOP and the IOP outcome 6 months postoperatively using Goldmann applanation tonometry. Data were presented as frequencies and mean ± standard deviation. Wilcoxon signed-ranks test was used to analyze the changes in the measurement of IOP after trabeculectomy. Results: Fifty-seven cases had trabeculectomy with a mean age of 51.6 ± 12.2 years. There was a statistically difference (P < 0.0001) in the IOP measurement pre and 6 months post trabeculectomy. 39 patients (68.4%) achieved an IOP of ≤21 mmHg 6 months after surgery without medications. IOP decreased from 33.2 ± 6.5 mmHg before surgery to 18.8 ± 5.8 mmHg after surgery. All the cases with preoperative IOP of 21–30 mmHg had a posttrabeculectomy IOP ≤ 21 mmHg (P < 0.0001). The rate of complications was low; seven eyes (12.3%) developed early postoperative complications that resolved within 2 weeks. Conclusions: This is the first report on trabeculectomy surgery in Libya. The results are encouraging with a low complication rate. This warrants further evaluationsof long term outcomes.

Key-words:

Intraocular pressure - Libya - primary open-angle glaucoma - trabeculectomy

Financial support and sponsorship

Nil.




Publication History

Received: 21 November 2020

Accepted: 13 January 2021

Article published online:
14 July 2022

© 2021. The Libyan Authority of Scientific Research and Technologyand the Libyan Biotechnology Research Center. All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License,permitting copying and reproductionso long as the original work is given appropriate credit. Contents may not be used for commercial purposes, oradapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kabiru J, Bowman R, Wood M, Mafwiri M. Audit of trabeculectomy at a tertiary referral hospital in East Africa. J Glaucoma 2005;14:432-4.
  • 2 Spaeth GL. Ophthalmic Surgery: Principles and Practice. 2nd ed. Philadelphia: WB Saunders; 1990. p. 286-303.
  • 3 South Central Ambulance Service. NHS Foundation Trust. Approval Process Information Sheet; August 2019. Available from: https://www.scas.nhs.uk/wp-content/uploads/Approval-process-Information-Sheet.pdf. [Last accessed on 2020 Oct 20].
  • 4 Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006;90:262-7.
  • 5 Prum BE Jr., Rosenberg LF, Gedde SJ, Mansberger SL, Stein JD, Moroi SE, et al. Primary open-angle glaucoma preferred practice pattern (R) guidelines. Ophthalmology 2016;123:P41-111.
  • 6 Artini W. Outcome of primary angle closure glaucoma management in Indonesian population. J Indonesian Med Assoc 2011;61:280-4.
  • 7 Saputro E, Rifada M, Soeherman R. Success rate of trabeculectomy in primary glaucoma at Cicendo eye hospital on January–December 2013. Althea Med J 2016;3:110-4.
  • 8 Musch DC, Gillespie BW, Lichter PR, Niziol LM, Janz NK, CIGTS Study Investigators. Visual field progression in the collaborative initial glaucoma treatment study the impact of treatment and other baseline factors. Ophthalmology 2009;116:200-7.
  • 9 Law SK, Modjtahedi SP, Mansury A, Caprioli J. Intermediate-term comparison of trabeculectomy with intraoperative mitomycin-C between Asian American and Caucasian glaucoma patients: A case-controlled comparison. Eye (Lond) 2007;21:71-8.
  • 10 Kim HY, Egbert PR, Singh K. Long-term comparison of primary trabeculectomy with 5-fluorouracil versus mitomycin C in West Africa. J Glaucoma 2008;17:578-83.
  • 11 Wong MH, Husain R, Ang BC, Gazzard G, Foster PJ, Htoon HM, et al. The Singapore 5-fluorouracil trial: Intraocular pressure outcomes at 8 years. Ophthalmology 2013;120:1127-34.
  • 12 Kirwan JF, Lockwood AJ, Shah P, Macleod A, Broadway DC, King AJ, et al. Trabeculectomy outcomes group audit study group. Trabeculectomy in the 21st century: A multicenter analysis. Ophthalmology 2013;120:2532-9.
  • 13 Yalvac IS, Sahin M, Eksioglu U, Midillioglu IK, Aslan BS, Duman S. Primary viscocanalostomy versus trabeculectomy for primary open-angle glaucoma: Three-year prospective randomized clinical trial. J Cataract Refract Surg 2004;30:2050-7.
  • 14 Mwanza JC, Kabasele PM. Trabeculectomy with and without mitomycin-C in a black African population. Eur J Ophthalmol 2001;11:261-3.
  • 15 Mermoud A, Salmon JF, Murray AD. Trabeculectomy with mitomycin C for refractory glaucoma in blacks. Am J Ophthalmol 1993;116:72-8.
  • 16 Saeed AM. Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM) and trabeculectomy with antimetabolite (MMC) in the treatment of primary open angle glaucoma. Clin Ophthalmol 2012;6:1651-64.
  • 17 El Sayyad F, Helal M, El-Kholify H, Khalil M, El-Maghraby A. Nonpenetrating deep sclerectomy versus trabeculectomy in bilateral primary open-angle glaucoma. Ophthalmology 2000;107:1671-4.
  • 18 Ashaye AO, Komolafe OO. Post-operative complication of trabeculectomy in Ibadan, Nigeria: Outcome of 1-year follow-up. Eye (Lond) 2009;23:448-52.
  • 19 Jay JL, Murray SB. Characteristics of reduction of intraocular pressure after trabeculectomy. Br J Ophthalmol 1980;64:432-5.
  • 20 Nesaratnam N, Sarkies N, Martin KR, Shahid H. Pre-operative intraocular pressure does not influence outcome of trabeculectomy surgery: A retrospective cohort study. BMC Ophthalmol 2015;15:17.
  • 21 Olayanju JA, Hassan MB, Hodge DO, Khanna CL. Trabeculectomy-related complications in Olmsted County, Minnesota, 1985 through 2010. JAMA Ophthalmol 2015;133:574-80.
  • 22 Edmunds B, Thompson JR, Salmon JF, Wormald RP. The national survey of trabeculectomy. III. Early and late complications. Eye (Lond) 2002;16:297-303.
  • 23 Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC, et al. Tube vs. Trabeculectomy Study Group. Postoperative complications in the Tube vs. trabeculectomy (TVT) study during five years of follow-up. Am J Ophthalmol 2012;153:804-14.e1.
  • 24 Pederson JE. Ocular hypotony. In: Ritch R, Krupin T, Shields MB, editors. The Glaucomas. 2nd ed.. St. Louis: Mosby; 1996. p. 385-95.
  • 25 Singh K, Byrd S, Egbert PR, Budenz D. Risk of hypotony after primary trabeculectomy with antifibrotic agents in a black west African population. J Glaucoma 1998;7:82-5.