Outcome of repeat trabeculectomies


Mr Anthony J King, Department of Ophthalmology and Visual Sciences, Nottingham University Hospital, Derby Road, Nottingham NG7 2UH, UK. Email: anthony.king@nuh.nhs.uk


Background:  To determine the success of repeat trabeculectomy augmented with mitomycin C in a cohort of patients who had undergone previously failed trabeculectomy surgery.

Design:  A consecutive cohort series of patients.

Participants:  Fifty patients undergoing augmented trabeculectomy surgery following a previously failed trabeculectomy and at least 12 months' follow up.

Methods:  All patients had demographic and clinical data collected at the time of surgery and at all subsequent follow-up visits.

Main Outcome Measures:  Visual field progression, loss of visual acuity, intraocular pressure (IOP) control.

Results:  The mean follow up was 36.7 months. Forty-one patients (82%) achieved an IOP ≤21 mmHg (with ≥20% reduction of preoperative IOP) and ≥6 mmHg on no additional glaucoma treatment at 12 months' follow up. Forty-four patients (88%) achieved a qualified success with the same criteria at 1 year. The median logMAR acuity preoperative was unchanged after surgery; however, 11 patients (22%) lost ≥2 Snellen lines during follow up. There was no significant change in mean deviation during the follow-up period.

Conclusions:  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.