ABSTRACT. Purpose: To evaluate the outcome, long-term results and contributing prognostic factors of trabeculectomy in terms of intraocular pressure (IOP) and to compare the results in primary open-angle glaucoma (POAG) and exfoliation glaucoma (EG).Methods: This study involved retrospective evaluation of 138 consecutive patients (138 eyes) with either POAG or EG. All patients had undergone primary trabeculectomy performed by the same surgeon between November 1994 and August 1996. Only one eye per patient was included. Operations performed with the use of antimetabolites were excluded. All patients were aged over 40 years and were white. Follow-up for all subjects lasted at least 2 years. Successful control of IOP was defined as achieving IOP Յ 21 mmHg without medication (complete success) or with a single topical medication (qualified success). Success rates were determined using the Kaplan-Meier survival curve, and risk factors were analysed with proportional hazards regression. Results: According to the Kaplan-Meier survival curve, success rates (complete or qualified) were 82% at 1 year, 70% at 2 years, 64% at 3 years and 52% at 4 years. A total of 63% were complete successes at 1 year, 54% at 2 years, 45% at 3 years and 40% at 4 years. Complete success rates were significantly better in the POAG group than in the EG group. Proportional hazards regression analysis showed that the presence of EG and early postoperative IOP Ͼ 30 mmHg decreased the possibility of complete success, while a cataract operation performed during follow-up improved it. Conclusion: The IOP-reducing effect of trabeculectomy decreases gradually. After 4 years, 52% of operated eyes had IOP Յ 21 mmHg with or without a single topical medication. Diagnosis of EG implied a worse long-term outcome for trabeculectomy in terms of IOP.

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The prognosis of patients with Type II (non-insulindependent) diabetes mellitus is primarily determined by the presence of macro-and microangiopathy. There is, however, a large variation in the propensity for the patient to develop these devastating complications. While poor glycaemic control and duration of diabetes are strong predictors of microangiopathy [1], their role as predictors of macroangiopathy is less clear [2±6]. In Type II diabetes, clustering of the metabolic syndrome (hyperglycaemia, obesity, hyper- Diabetologia (1998) Summary To test the hypothesis that interaction between genetic, immunological, clinical and metabolic risk factors influences the outcome of Type II (noninsulin-dependent) diabetes mellitus, we examined which of the above factors present at baseline were associated with mortality in 134 Type II diabetic patients followed for 9 years. Thirty-eight patients (29 %) died during the follow-up period; the majority of whom (68 %) died from cardiovascular disease. At baseline, the deceased patients had higher HbA 1 c values (p = 0.002), higher LDL-triglycerides (p = 0.007), lower HDL-cholesterol (p = 0.007), higher non-esterified fatty acid (NEFA) concentrations (p = 0.014), and higher albumin excretion rate (p < 0.0001) than the patients who survived. In addition, the frequency of HLA-DR4 (21 vs 39 %, p = 0.048) and of parietal cell antibodies (5 vs 14 %, p = 0.016) were decreased in the deceased as compared to the living patients.Patients who died during follow-up also had more retinopathy (42 vs 16 %, p = 0.002), neuropathy (57 vs 23 %, p < 0.001), microalbuminuria (45 vs 6 %, p < 0.0001), coronary heart disease (50 vs 13 %, p < 0.0001), and peripheral vascular disease (27 vs 9 %, p = 0.005) at baseline than patients who survived. In a multiple logistic regression analysis macroangiopathy (p = 0.004), neuropathy (p = 0.007), HbA 1 c (p = 0.018) and albumin excretion rate (p = 0.016) were independent risk factors for death. In patients free of cardiovascular disease at baseline, conventional risk factors such as LDL-cholesterol (p = 0.005) and age (p = 0.003) were associated with subsequent development of cardiovascular disease. In conclusion, in addition to coexisting macroangiopathy, increased albumin excretion rate, poor glycaemic control and neuropathy are risk factors for cardiovascular mortality in patients with Type II diabetes. The presence of HLA-DR4 and signs of autoimmunity may be associated with decreased risk of cardiovascular disease.[ Diabetologia (1998

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At 1 year, ICL implantation had good visual and refractive results with excellent biocompatibility. Long-term follow-up is required to confirm that significant complications do not occur in most patients over time.