Otago Glaucoma Surgery Outcome Study: long-term results of 841 trabeculectomies

  1. Tui H Bevin MPH1,
  2. Anthony CB Molteno FRCS1,
  3. Peter Herbison MSc2

Article first published online: 13 NOV 2008

DOI: 10.1111/j.1442-9071.2008.01896.x

Issue

Clinical & Experimental Ophthalmology

Clinical & Experimental Ophthalmology

Volume 36, Issue 8, pages 731–737, November 2008

Additional Information

How to Cite

Bevin, T. H., Molteno, A. C. and Herbison, P. (2008), Otago Glaucoma Surgery Outcome Study: long-term results of 841 trabeculectomies. Clinical & Experimental Ophthalmology, 36: 731–737. doi: 10.1111/j.1442-9071.2008.01896.x

Author Information

  1. 1

    Section of Ophthalmology, Department of Medical and Surgical Sciences, and

  2. 2

    Department of Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand

*Mrs Tui H Bevin, Section of Ophthalmology, Department of Medical and Surgical Sciences, University of Otago Dunedin School of Medicine, PO Box 913, Dunedin, New Zealand. Email: tui.bevin@stonebow.otago.ac.nz

Publication History

  1. Issue published online: 29 DEC 2008
  2. Article first published online: 13 NOV 2008
  3. Received 20 May 2008; accepted 14 October 2008.

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Keywords:

  • closed-angle glaucoma;
  • open-angle glaucoma;
  • trabeculectomy

Abstract

Background:  To describe the long-term outcomes of trabeculectomies performed at Dunedin Hospital and followed in the Otago Glaucoma Surgery Outcome Study.

Methods:  Prospective non-comparative case series of 841 eyes of 607 patients who had first trabeculectomies for primary open- or closed-angle glaucoma at Dunedin Hospital between 1976 and 2005 and followed for a mean of 7.5 years (standard deviation 6.0).

Results:  The probability of a trabeculectomy controlling the intraocular pressure at 21 mmHg or less at 1, 10 and 20 years was 0.96 (95% confidence interval [CI] 0.95, 0.97), 0.86 (95% CI 0.83, 0.89) and 0.79 (95% CI 0.74, 0.83), respectively. Visual acuity was maintained or improved between preoperative assessment and final follow up in 68% of cases. The probability of not being blind following trabeculectomy at 1, 10 and 20 years was 0.98 (95% CI 0.96, 0.98), 0.83 (95% CI 0.80, 0.87) and 0.70 (95% CI 0.64, 0.76), respectively. The proportion of those with glaucomatous field loss increased during follow up from 16% (44/283) at 0–5 years to 50% (10/20) for those with 21 or more years of follow up. A repeat drainage procedure was required in 65 eyes (8%) (56 Molteno implant insertions and 9 repeat trabeculectomies).

Conclusions:  Intraocular pressure was well controlled by trabeculectomy; however, a steady decline in intraocular pressure control, visual acuity and visual field occurred during follow up.

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