J Korean Ophthalmol Soc.  2014 Feb;55(2):252-260. 10.3341/jkos.2014.55.2.252.

Long-Term Outcomes of Trabeculectomy in Korean Patients with Juvenile Open-Angle Glaucoma

• Oh EK
• Lee EJ
• Jeoung JW
• Kim SH
• Kim TW
• Park KH
• Kim DM

• KMID: 2218419
• DOI: http://doi.org/10.3341/jkos.2014.55.2.252

Abstract

PURPOSE
To evaluate the outcomes and prognostic factors of trabeculectomy with mitomycin C in Korean patients with juvenile open-angle glaucoma (JOAG).
METHODS
A retrospective review was performed on 29 eyes with JOAG who had undergone trabeculectomy between January 2004 and January 2013. Intraocular pressure (IOP) and postoperative complications were monitored at 1 day preoperatively, at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively, and at final follow-up after postoperative 18 months. Surgical success was defined as a final IOP of <21 mm Hg or <80% of preoperative IOP, regardless of the use of anti-glaucoma medication. Prognostic factors for surgical success or failure were analyzed by the Cox proportional hazards model.
RESULTS
Mean (+/- standard deviation) age at trabeculectomy was 24.6 (+/- 8.9) years, and mean follow-up period was 24.3 (+/- 20.8) months. The overall success rate was 82.8% at final follow-up. The Kaplan-Meier cumulative probabilities of surgical success were 100% at 1 year, 87.4% at 2 years, and 78.7% at 3 years postoperatively. The Cox proportional hazards model failed to determine any significant factors that were associated with surgical failure. The three most frequent postoperative complications were immediately postoperative hypotony (n = 19, 65.5%), hypotony maculopathy (n = 8, 27.6%), and encapsulated bleb (n = 8, 27.6%), most of which were resolved after a minor procedure or observation. Two of 8 eyes with encapsulated bleb required a second surgery. There were no vision-threatening severe complications.
CONCLUSIONS
Trabeculectomy with MMC may be an effective treatment in Korean JOAG patients.

Keyword

Juvenile open-angle glaucoma; Prognostic factor; Surgical outcomes; Trabeculectomy

MeSH Terms

Blister
Follow-Up Studies
Glaucoma, Open-Angle*
Humans
Intraocular Pressure
Mitomycin
Postoperative Complications
Proportional Hazards Models
Retrospective Studies
Trabeculectomy*
Mitomycin

Figure

• 

  Figure 1. Kaplan-Meier survival curve of surgical outcome of trabeculectomy in patients with juvenile open angle glaucoma. The probabilities of surgical success were 100% at 1 year, 87.4% at 2 years, and 78.7% at 3 years postoperatively.

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  Figure 2. Mean intraocular pressure (IOP) change profile after trabeculectomy in juvenile open angle glaucoma patients. The postoperative IOP decreased significantly compared to the preoperative level during the whole follow-up period (mean final follow-up, 24.3 ± 20.8 months; all p < 0.001). Error bars indicate ± standard deviation.

• 

  Figure 3. Inter-eye comparison of Kaplan-Meier survival curves on the outcome of trabeculectomy in bilateral juvenile open angle glaucoma patients who underwent trabeculectomy in both eyes. The respective values of probabilities for surgical success were 53.9% and 88.9% in first- and second-operated eye at the end of the follow-up. Log-rank test revealed no statistical difference in the surgical outcome between two groups (p = 0.425).

Reference

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