The role of trabeculectomy in the treatment of advanced chronic angle-closure glaucoma.

SUMMARY: To examine the results and complications of trabeculectomy performed for advanced angle-closure glaucoma, a retrospective study was undertaken of 39 patients (46 eyes) who had chronic angle-closure glaucoma and who had undergone trabeculectomy during a 5-year period. The main indication for trabeculectomy was an inability to control the intraocular pressure with glaucoma medication. The surgery was not complicated by visual loss or malignant glaucoma. The intraocular pressure was successfully reduced to <21 mm Hg in 30 eyes (66.7%) without medication and in a further 11 eyes (24.4%) with additional topical glaucoma medication, after a mean follow-up period of 19 months. A second trabeculectomy was required in four patients (8.9%) (mean period: 35.8 months later) and a cataract extraction with intraocular lens implantation was required in nine patients (mean period: 23.9 months later). These results indicate that although trabeculectomy is effective and relatively safe in the management of advanced chronic angle-closure glaucoma, at least one in three patients will require a second operation within 3 years.