Outcome of repeat trabeculectomies

Olali, C; Rotchford, Alan P; King, Anthony J

doi:10.1111/j.1442-9071.2011.02519.x

Cited by 28 publications

(24 citation statements)

References 29 publications

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“…Olali et al15 used the same technique of trabeculectomy with MMC application. They reported a comparable result (54% success rate) to that of our control group, which is much less than our combined approach (77%).…”

Section: Discussionmentioning

confidence: 99%

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Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

Saeed¹,

AboulNasr²

2014

OPTH

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PurposeTo provide a feasible solution to the problem of failed glaucoma surgery. The aim was to evaluate the efficacy and safety of the additional effects of a combined surgical approach. This approach augments the application of trabeculectomy with mitomycin C (MMC) by adding subconjunctival bevacizumab injection. The results were compared with those of trabeculectomy with only adjunctive MMC.MethodsA randomized controlled prospective clinical trial included 28 eyes diagnosed with failed scarred bleb of a previous trabeculectomy. The eyes were divided into two equal groups: combined group A, “trabeculectomy with adjunctive MMC and subconjunctival bevacizumab,” and control group B, “trabeculectomy with adjunctive MMC only.” The main outcome results included the cumulative probability of surgical success, intraocular pressure (IOP) values, and number of IOP-lowering medications needed to achieve the target IOP.ResultsGroup A achieved a cumulative probability of complete success of 0.769 and of qualified success of 0.231 at the end of the 24 month study period; group B achieved cumulative probabilities of 0.538 and 0.308, respectively. Group A achieved a lower mean IOP value than group B, with fewer antiglaucoma drugs at all postoperative visits, but this lower value did not reach a statistically significant level (P>0.05). There was no statistically significant difference between both groups regarding best corrected visual acuity, visual field parameters, operative and/or postoperative complications, and additional interventions. No significant adverse effects were caused by this combined approach.ConclusionBevacizumab was not found to add much to the favorable long-term outcome of conventional trabeculectomy with MMC as a solution to the problem of scarred failed bleb.

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Section: Discussionmentioning

confidence: 99%

“…Adjunctive antimetabolite (ie, MMC) is mandatory in these cases 15. The application of bevacizumab at the time of surgery could temporarily block the postoperative increased VEGF concentration and its level of upregulation in the aqueous humor 16…”

Section: Introductionmentioning

confidence: 99%

Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

Saeed¹,

AboulNasr²

2014

OPTH

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“…The IOP of all the patients prior to SLT was >15 mmHg and the IOP of 77.8% of the patients was >18 mmHg, with the average follow-up period of 6.3 months. The IOP of 27.8% of the patients was <15 mmHg, and the patients with an IOP >18 mmHg saw a reduction in their IOP by 16.7%. The changes in IOP distribution prior and subsequent to SLT are shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The difficulty of repeat trabeculectomy in these Selective laser trabeculoplasty in treating post-trabeculectomy advanced primary open-angle glaucoma patients is significant. It is widely acknowledged that prior incisional surgery decreases the success rate of subsequent surgery for glaucoma (16). This is the most difficult issue in the treatment of glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Selective laser trabeculoplasty in treating post-trabeculectomy advanced primary open-angle glaucoma

Zhang

Yang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of this study was to investigate the safety and efficacy of selective laser trabeculoplasty (SLT) treatment of patients with primary open-angle glaucoma (POAG) who could not obtain target intraocular pressure (IOP) through post-trabeculectomy medication. Sixteen patients with POAG (18 eyes), who could not obtain target IOP following medication and surgery, were treated with 360˚ SLT. The IOP, anterior chamber inflammation, and daytime and long-term IOP fluctuations before and 2 h, 1 day, 7 days, 1 month, 3 months, 6 months and 9 months after SLT were documented. SLT treatment success was defined as >20% IOP reduction compared with the baseline IOP at 6 and 9 months after the laser treatment date. Prior to SLT, the patients were administered different types (average, 2.8±0.8) of anti-glaucoma drugs and had an average IOP of 21.3±3.4 mmHg. Following SLT, the average IOP decreased to 16.2±3.0 mmHg and the success rate was 77.7%. The pre-SLT daytime IOP fluctuation was 4.1±1.4 mmHg, which decreased to 2.6±1.1 mmHg following the laser treatment (P<0.05). In conclusion, this study demonstrated that SLT could reduce the IOP in post-trabeculectomy patients with POAG, and reduce the daytime IOP fluctuations.

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“…A possible explanation may be that repeat trabeculectomies were done with the use of antifibrotic agents. Indeed Broadway et al [33] reported that trabeculectomies following conjunctival incisional operations were more likely to fail compared to primary trabeculectomies More recent studies confirmed that repeat trabeculectomies augmented by intraoperative use of mitonycin C is an effective procedure for IOP control [34,35] • Secondary glaucomas (traumatic, uveitic, aphakic, rubeotic). Mietz et al [36] found that the neovascular, traumatic and uveitic glaucoma had the worst prognosis regarding trabeculectomy survival.…”

Section: Risk Factors In Trabeculectomymentioning

confidence: 99%

Combined Cataract-Glaucoma Surgery

Kozobolis¹,

Konstantinidis²,

Labiris³

2013

Glaucoma - Basic and Clinical Aspects

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Outcome of repeat trabeculectomies

Abstract: Repeating trabeculectomy augmented with mitomycin C is an effective method of controlling IOP and preventing further visual deterioration in the majority of patients treated. However, visual loss was seen in a significant proportion of patients.

Cited by 28 publications

References 29 publications

Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

Selective laser trabeculoplasty in treating post-trabeculectomy advanced primary open-angle glaucoma

Combined Cataract-Glaucoma Surgery

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