Outcome of Conventional Trabeculectomy in Terms of Intraocular Pressure and Visual Acuity in Primary Open Angle Glaucoma

Abstract

Purpose: To determine the outcomes of conventional trabeculectomy in terms of decrease in Intra Ocular Pressure (IOP) and improvement in visual acuity in patients of primary open glaucoma, coming to a tertiary care hospital.
 Study Design: Retrospective case series.
 Place and Duration of Study: Ophthalmology department of a tertiary care hospital from January 2017 to December 2018.
 Methods: Patients undergoing trabeculectomy for Primary open angle glaucoma were included. Patients with repeated trabeculectomy, failed argon laser trabeculoplasty, advance cataract, corneal opacities and absolute glaucoma were excluded. All the trabeculectomies were done under retrobulbar anaesthesia after taking all aseptic measures. Primary outcome measures were preoperative and postoperative visual acuity, intraocular pressure, number of antiglaucoma medications and failed or successful trabeculectomy.
 Results: Total 52 patients underwent trabeculectomy. There were 36 (69.2%) males and 16 (30.8%) females. Mean age was 56.73 years ± 10.9 SD. Mean preoperative IOP was 30.96 ± 6.71 mm Hg, post operatively IOP at 1 year it was 15.6 ± 4.2 mm Hg. P value was <.000. Mean number of antiglaucoma medications was 3.03 and 1.19, pre and post-operatively respectively (p value <.000). Improvement in visual acuity after trabeculectomy was seen in 32 (61.5%) patients. Complete Surgical success was seen in 28 (53.8%) and qualified success in 21 (40.4%) patients. Failed trabeculectomy was seen in 3 (5.8%) patients.
 Conclusion: Conventional trabeculectomy is effective in lowering IOP in primary open angle glaucoma patients. It maintains IOP within normal range with and without anti-glaucoma medications at 1 year follow-up. Trabeculectomy significantly reduces number of anti-glaucoma medications.
 Key Words: Intraocular pressure, Primary open angle glaucoma, Trabeculectomy.

Outcomes of Trabeculectomy at a Newly Established Glaucoma Clinic in Khyber Pakhtunkhwa

“…On the other hand, there was no statistically significant change in visual acuity of our patients which is in line with other studies reported. 4,9,11 The mean decrease in IOP noted in our study was similar to the results of a study conducted by Shahid et al 4 Similarly, a study conducted in Nigeria also reported a significant reduction in IOP. 12 Even though a higher IOP reduction was reported in our study, setting a target pressure is always individualized according to the patient individual characteristics.…”

“…3 Pakistan has a burden of over 1.8 million people suffering from glaucoma with more and more people becoming blind to this disease due to delayed presentation primarily due to lack of knowledge. 4 Control of intraocular pressure (IOP) can be achieved with IOP-lowering topical medications, OPEN ACCESS lasers, or surgery. Trabeculectomy, a filtration surgery, first introduced by Cairns in 1968 and then modified subsequently by Watson in 1970, has been the Gold Standard surgical procedure for Glaucoma.…”

Outcomes of Manual Small Incision Cataract Surgery in Hypermature Morgagnian cataract

“…An intraoperative complication rate of MSICS in HMCs was 14.3% in our study, which is marginally better than the 16% reported in ECCE. 20 However, Vajpayee et al in his study, on “Phacoemulsification in hypermature cataract,” evaluated the visual outcome in 25 patients and reported a nil complication rate. Nevertheless, it is important to note that all patients included in this study did not have any preoperative risk factors.…”