Abstract
Objective
To describe the outcomes of patients who underwent a single ab interno trabeculectomy
revision augmented with 5-fluorouracil.
Design
Retrospective cohort study.
Participants
All patients who had undergone ab interno trabeculectomy revision at a single tertiary
care centre during the 5-year study period. All patients had advanced glaucomatous
optic neuropathy, and all treated ages and glaucoma subtypes were included.
Methods
Outcome measures included surgical success, number of topical intraocular pressure
(IOP)–lowering drops, best-corrected visual acuity, visual field mean deviation, and
postoperative complications. Success at 12 months was defined using 2 criteria: criterion
A (IOP <15 mm Hg and >20% reduction) and criterion B (IOP <12 mm Hg and >20% reduction).
Each success criterion was subdivided into patients who achieved success without topical
IOP-lowering drops (complete success) or with topical therapy (qualified success).
Results
This study included 46 eyes of 46 patients. Of these, 34 patients were followed for
12 months or more to assess surgical success. Success defined by criterion A was achieved
by 68% of these 34 patients (53% complete, 15% qualified). Success defined by criterion
B was achieved by 47% of these patients (38% complete, 9% qualified). Early hypotony
was noted in 68% of eyes but was not associated with negative visual acuity or visual
field outcomes.
Conclusions
An IOP of <12 mm Hg and a >20% IOP reduction were achieved by 47% of patients overall
(with or without topical therapy) at 12 months of follow-up. Transient early postoperative
hypotony should be expected following ab interno revision trabeculectomy.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Canadian Journal of OphthalmologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Global magnitude of visual impairment caused by uncorrected refractive errors in 2004.Bull WHO. 2008; 86: 63-70
- Le glaucome primitif à angle ouvert [Primary open-angle glaucoma].Rev Med Interne. 2019; 40: 445-452
- The optimal trabeculectomy: patient and procedure.Can J Ophthalmol. 2014; 49: 523-527
- Perioperative complications of trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS).Am J Ophthalmol. 2005; 140: 16-22
- Revision trabeculectomy: pearls and pitfalls.J Curr Glaucoma Pract. 2012; 6: 131-138
- Needle revision outcomes after glaucoma filtering surgery: survival analysis and predictive factors.Eur J Ophthalmol. 2020; 30: 350-359
- Risk factors for failure of 5-fluorouracil needling revision for failed conjunctival filtration blebs.Am J Ophthalmol. 2001; 132: 875-880
- Outcomes: trabeculectomy bleb needle revision with 5-fluorouracil.J Glaucoma. 2016; 25: 317-323
- Filtering bleb revision techniques.in: Thomas JV Glaucoma surgery. St. Louis. Mosby–Year Book, St. Louis1992: 75-82
- Outcomes for ab interno bleb revision with a novel translimbal sclerostomy spatula.J Glaucoma. 2017; 26: 633-637
- 5-Fluorouracil for glaucoma surgery.Cochrane Database Syst Rev. 2014; CD001132
- Corneal endothelial toxic effect secondary to fluorouracil needle bleb revision.Arch Ophthalmol. 1995; 113: 1093-1094
- Effect of mitomycin C and fluorouracil-supplemented trabeculectomies on the anterior segment.Arch Ophthalmol. 1995; 113: 578-580
- Stem cells and corneal epithelial regeneration.Eye (Lond). 1994; 8: 170-183
Article info
Publication history
Published online: December 05, 2022
Accepted:
November 9,
2022
Received in revised form:
October 16,
2022
Received:
January 17,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
