BACKGROUND: To identify the baseline factors influencing success following trabeculectomy with mitomycin C in a case series of African-Caribbean patients. DESIGN: A prospective, observational and non-comparative cohort study. PARTICIPANTS: Forty-seven consecutive African-Caribbean patients (47 eyes) with glaucoma. METHODS: Association between trabeculectomy survival and study factors was examined using Fisher's exact test and the Wilcoxon rank sum test at 12, 24 and 36 months following trabeculectomy. Logistic regression was used to establish the combination of factors best predicting survival. MAIN OUTCOME MEASURES: Surgical success was based upon intraocular pressure reduction to ≤21 mmHg, ≤18 mmHg and ≤15 mmHg without glaucoma medication (criterion 1), or intraocular pressure reduction to ≤21 mmHg, ≤18 mmHg and ≤15 mmHg with or without glaucoma medication (criterion 2). RESULTS: Trabeculectomy survival at 36 months was significantly decreased with the use of preoperative acetazolamide, pseudophakic status and higher preoperative intraocular pressure (P < 0.05). In pseudophakic eyes, there was a lower rate of success for criterion 2 when aiming for an intraocular pressure ≤15 mmHg at 2 years post-trabeculectomy, the odds ratio being 12. CONCLUSIONS: Three major independent risk factors were identified that influenced trabeculectomy failure at 3 years in African-Caribbean ethnicity: the preoperative use of acetazolamide, pseudophakic status and higher preoperative intraocular pressure. The presence of these risk factors may guide the clinician to use a more aggressive antiproliferative and postoperative management regime to enhance survival rates in this high-risk population.
BACKGROUND: To identify the baseline factors influencing success following trabeculectomy with mitomycin C in a case series of African-Caribbean patients. DESIGN: A prospective, observational and non-comparative cohort study. PARTICIPANTS: Forty-seven consecutive African-Caribbean patients (47 eyes) with glaucoma. METHODS: Association between trabeculectomy survival and study factors was examined using Fisher's exact test and the Wilcoxon rank sum test at 12, 24 and 36 months following trabeculectomy. Logistic regression was used to establish the combination of factors best predicting survival. MAIN OUTCOME MEASURES: Surgical success was based upon intraocular pressure reduction to ≤21 mmHg, ≤18 mmHg and ≤15 mmHg without glaucoma medication (criterion 1), or intraocular pressure reduction to ≤21 mmHg, ≤18 mmHg and ≤15 mmHg with or without glaucoma medication (criterion 2). RESULTS: Trabeculectomy survival at 36 months was significantly decreased with the use of preoperative acetazolamide, pseudophakic status and higher preoperative intraocular pressure (P < 0.05). In pseudophakic eyes, there was a lower rate of success for criterion 2 when aiming for an intraocular pressure ≤15 mmHg at 2 years post-trabeculectomy, the odds ratio being 12. CONCLUSIONS: Three major independent risk factors were identified that influenced trabeculectomy failure at 3 years in African-Caribbean ethnicity: the preoperative use of acetazolamide, pseudophakic status and higher preoperative intraocular pressure. The presence of these risk factors may guide the clinician to use a more aggressive antiproliferative and postoperative management regime to enhance survival rates in this high-risk population.
Authors: Andrew H Nguyen; Nima Fatehi; Pablo Romero; Arezoo Miraftabi; EunAh Kim; Esteban Morales; JoAnn Giaconi; Anne L Coleman; Simon K Law; Joseph Caprioli; Kouros Nouri-Mahdavi Journal: JAMA Ophthalmol Date: 2018-10-01 Impact factor: 7.389
Authors: Heiko Philippin; Einoti Matayan; Karin M Knoll; Edith Macha; Sia Mbishi; Andrew Makupa; Cristóvão Matsinhe; Vasco da Gama; Mario Monjane; Awum Joyce Ncheda; Francisco Alcides Mulobuana; Elisante Muna; Nelly Fopoussi; Gus Gazzard; Ana Patricia Marques; Peter Shah; David Macleod; William U Makupa; Matthew J Burton Journal: Lancet Glob Health Date: 2021-10-13 Impact factor: 38.927