Audit of Trabeculectomy at a Tertiary Referral Hospital in East Africa

Abstract

The results of surgery compare well with other reported series. 5FU did not demonstrate significant benefit in terms of intraocular pressure lowering beyond 2 months postoperatively. Early postoperative hypotony should be avoided. The gender difference in intraocular pressure results has not previously been reported and deserves further investigation.

Post-operative complication of trabeculectomy in Ibadan, Nigeria: outcome of 1-year follow-up

“…The mean reduction in IOP from 32.2 mm Hg (median ¼ 30.5; SD ¼ 11.4) in the preoperative period to 17.8 mm Hg (median ¼ 17.0; SD ¼ 5.8) at a year follow-up compares with report from other previous studies. 4,[17][18][19] There was no significant difference between the 5-FU and the non-5-FU groups at a year follow-up in term of their mean IOP (P ¼ 0.6). The survival curve between the two groups also failed to demonstrate any added advantage to the use of antimetabolites.…”

“…Shallow anterior chamber ranked highest in the list of early post-operative complications and is similar to what had being reported in some other previous studies. 4,12,15,[20][21] There was no clinically documented case of choroidal effusion/detachment, the incidence of which is very low among blacks compared to Caucasians. This study showed no significant correlation between the use of 5-FU and the presence of postoperative shallow anterior chamber.…”

“…The difference was not statistically significant (log rank P ¼ 0.136; Breslow P ¼ 0.67). There has been conflicting report concerning the complications and long-term outcome of trabeculectomy in term of IOP control and the intraoperative use of antimetabolite (5-FU) Kabiru et al 4 and Leyland et al 20 found no added advantage in the use of antimetabolite. However, some other studies 21,22 reported a significant benefit with the use of intraoperative use of 5-FU.…”

“…1 It continues to outperform both medical and laser treatment in this regard, 2,3 especially in Africans where availability of and compliance with topical therapy are limited. 4 Also, trabeculectomy has been reported to be more beneficial in Africans in term of IOP lowering effect and slowing down of field loss. [5][6][7] The goal of the surgery is to establish a permanent flow of aqueous from the anterior chamber to the subconjuctival space thereby lowering the IOP.…”

“…Studies have reported various types of complications following trabeculectomy with incidence differing from one study to another 4,[12][13][14][15][16] depending on the duration of follow-up, the study population and the surgical techniques such as the use of antimetabolite and releasable sutures. Some of these complications are self-limiting while some adversely affect the overall success of the procedure.…”