Kenji Kashiwagi1, Satoshi Kogure2, Fumihiko Mabuchi2, Tatsuya Chiba2, Tetsuya Yamamoto3, Yasuaki Kuwayama4, Makoto Araie5. 1. Department of Ophthalmology, University of Yamanashi, Faculty of Medicine, Chuo Yamanashi, Japan. kenjik@yamanashi.ac.jp. 2. Department of Ophthalmology, University of Yamanashi, Faculty of Medicine, Chuo Yamanashi, Japan. 3. Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan. 4. Fukushima Eye Clinic, Osaka, Japan. 5. Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Abstract
PURPOSE: To report the 5-year incidence of visual impairment after mitomycin C-augmented trabeculectomy (MMC trabeculectomy) and the risk factors for visual impairment. METHODS: This is a multicentre prospective observational cohort study. Among glaucoma patients registered in the Collaborative Bleb-related Infection Incidence and Treatment Study performed in Japan, the patients with eyes meeting the following qualifications were included: eyes with primary open-angle glaucoma; eyes with primary angle-closure glaucoma; eyes with exfoliative glaucoma; eyes with ≥3/60 in blindness analysis; and eyes with ≥20/60 in low-vision analysis and visual acuity loss analysis. The patients were followed at 6-month intervals for 5 years. The entry data and follow-up data were analysed to determine the incidence of blindness (<3/60), low vision (≥3/60 and <20/60) and visual acuity loss (≥0.2 logMAR) during the follow-up period. Risk factors for visual impairment were also analysed. RESULTS: A total of 694 eyes of 694 or 559 eyes of 559 glaucoma patients were subjected to the blindness analysis or the low-vision and visual acuity loss analysis, respectively. Visual acuity significantly deteriorated (p < 0.0001): 12.2% (95%CI: 9.8-14.7%) of the patients became blind; 12.1% (95%CI: 9.4-14.9%) were judged to have low vision at the final examination; 28.3% (95%CI: 24.5-32.0%) were judged to have visual acuity loss. Glaucoma subtypes, poor preoperative visual function and postoperative complications are the main risk factors for visual impairment. CONCLUSIONS: Visual acuity was significantly reduced after MMC trabeculectomy in 5 years, and we identified several risk factors associated with this complication.
PURPOSE: To report the 5-year incidence of visual impairment after mitomycin C-augmented trabeculectomy (MMC trabeculectomy) and the risk factors for visual impairment. METHODS: This is a multicentre prospective observational cohort study. Among glaucomapatients registered in the Collaborative Bleb-related Infection Incidence and Treatment Study performed in Japan, the patients with eyes meeting the following qualifications were included: eyes with primary open-angle glaucoma; eyes with primary angle-closure glaucoma; eyes with exfoliative glaucoma; eyes with ≥3/60 in blindness analysis; and eyes with ≥20/60 in low-vision analysis and visual acuity loss analysis. The patients were followed at 6-month intervals for 5 years. The entry data and follow-up data were analysed to determine the incidence of blindness (<3/60), low vision (≥3/60 and <20/60) and visual acuity loss (≥0.2 logMAR) during the follow-up period. Risk factors for visual impairment were also analysed. RESULTS: A total of 694 eyes of 694 or 559 eyes of 559 glaucomapatients were subjected to the blindness analysis or the low-vision and visual acuity loss analysis, respectively. Visual acuity significantly deteriorated (p < 0.0001): 12.2% (95%CI: 9.8-14.7%) of the patients became blind; 12.1% (95%CI: 9.4-14.9%) were judged to have low vision at the final examination; 28.3% (95%CI: 24.5-32.0%) were judged to have visual acuity loss. Glaucoma subtypes, poor preoperative visual function and postoperative complications are the main risk factors for visual impairment. CONCLUSIONS: Visual acuity was significantly reduced after MMC trabeculectomy in 5 years, and we identified several risk factors associated with this complication.
Authors: Markus Lenzhofer; Clemens Strohmaier; Melchior Hohensinn; Wolfgang Hitzl; Veit Steiner; Björn Baca; Sarah Moussa; Karolina Motloch; Herbert A Reitsamer Journal: Graefes Arch Clin Exp Ophthalmol Date: 2019-09-07 Impact factor: 3.117
Authors: Markus Lenzhofer; Inga Kersten-Gomez; Arsham Sheybani; Husayn Gulamhusein; Clemens Strohmaier; Melchior Hohensinn; H Burkhard Dick; Wolfgang Hitzl; Lisa Eisenkopf; Fady Sedarous; Iqbal I Ahmed; Herbert A Reitsamer Journal: Clin Exp Ophthalmol Date: 2019-02-03 Impact factor: 4.207