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Prognostic factors in trabeculectomy with mitomycin C having history of previous glaucoma surgery

  • Clinical Investigation
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Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the prognostic factors for surgical outcomes of subsequent trabeculectomy with mitomycin C (MMC) after prior incisional glaucoma surgery.

Methods

We reviewed medical records of a total cohort of 781 trabeculectomies with MMC, and selected 125 patients (125 eyes). The primary endpoints included persistent intraocular pressure (IOP) of ≥21 or <5 mmHg, the need for additional glaucoma surgery and deterioration of visual acuity to no light perception. Univariate and Multivariate analyses were performed by using the Cox proportional hazards model.

Results

The mean follow-up period was 26.8 months. The probabilities of success at 1, 2, and 3 years were 80.6, 72.2, and 70.6 %, respectively. Multivariate analysis showed that a shorter time interval between prior glaucoma surgery and subsequent trabeculectomy [relative risk (RR), 0.8867/year; P = 0.0090] and the number of prior trabeculectomies (RR, 2.2645; P = 0.0029) were significant prognostic factors for subsequent failure of trabeculectomy with MMC.

Conclusion

A short time period between prior glaucoma surgery and subsequent trabeculectomy and the number of prior trabeculectomies are associated with surgical failure of subsequent trabeculectomy with MMC.

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References

  1. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90:262–7.

    Article  PubMed  CAS  Google Scholar 

  2. Rachmiel R, Trope GE, Chipman ML, Gouws P, Buys YM. Effect of medical therapy on glaucoma filtration surgery rates in Ontario. Arch Ophthalmol. 2006;124:1472–7.

    Article  PubMed  Google Scholar 

  3. Jay JL, Murray SB. Early trabeculectomy versus conventional management in primary open angle glaucoma. Br J Ophthalmol. 1988;72:881–9.

    Article  PubMed  CAS  Google Scholar 

  4. Migdal C, Gregory W, Hitchings R. Long-term functional outcome after early surgery compared with laser and medicine in open-angle glaucoma. Ophthalmology. 1994;101:1651–6 discussion 1657.

    Article  PubMed  CAS  Google Scholar 

  5. Musch DC, Gillespie BW, Lichter PR, Niziol LM, Janz NK, CIGTS Study Investigators. Visual field progression in the Collaborative Initial Glaucoma Treatment Study: the impact of treatment and other baseline factors. Ophthalmology. 2009;116:200–7.

    Article  PubMed  Google Scholar 

  6. Law SK, Shih K, Tran DH, Coleman AL, Caprioli J. Long-term outcomes of repeat vs initial trabeculectomy in open-angle glaucoma. Am J Ophthalmol. 2009;148:685–95.e681.

    Google Scholar 

  7. Takihara Y, Inatani M, Fukushima M, Iwao K, Iwao M, Tanihara H. Trabeculectomy with mitomycin C for neovascular glaucoma: prognostic factors for surgical failure. Am J Ophthalmol. 2009;147:912–8, 918.e911.

    Google Scholar 

  8. Kitazawa Y, Kawase K, Matsushita H, Minobe M. Trabeculectomy with mitomycin. A comparative study with fluorouracil. Arch Ophthalmol. 1991;109:1693–8.

    Article  PubMed  CAS  Google Scholar 

  9. Broadway DC, Chang LP. Trabeculectomy, risk factors for failure and the preoperative state of the conjunctiva. J Glaucoma. 2001;10:237–49.

    Article  PubMed  CAS  Google Scholar 

  10. Fontana H, Nouri-Mahdavi K, Lumba J, Ralli M, Caprioli J. Trabeculectomy with mitomycin C: outcomes and risk factors for failure in phakic open-angle glaucoma. Ophthalmology. 2006;113:930–6.

    Article  PubMed  Google Scholar 

  11. Fontana H, Nouri-Mahdavi K, Caprioli J. Trabeculectomy with mitomycin C in pseudophakic patients with open-angle glaucoma: outcomes and risk factors for failure. Am J Ophthalmol. 2006;141:652–9.

    Article  PubMed  CAS  Google Scholar 

  12. Musch DC, Gillespie BW, Niziol LM, Cashwell LF, Lichter PR, Collaborative Initial Glaucoma Treatment Study Group. Factors associated with intraocular pressure before and during 9 years of treatment in the collaborative initial glaucoma treatment study. Ophthalmlogy. 2008;115:927–33.

    Article  Google Scholar 

  13. Takihara Y, Inatani M, Seto T, Iwao K, Iwao M, Inoue T, et al. Trabeculectomy with mitomycin for open-angle glaucoma in phakic vs pseudophakic eyes after phacoemulsification. Arch Ophthalmol. 2011;129:152–7.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by JSPS KAKENHI Grant Number 23390403, 23791994.

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Correspondence to Toshihiro Inoue.

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Awai-Kasaoka, N., Inoue, T., Inatani, M. et al. Prognostic factors in trabeculectomy with mitomycin C having history of previous glaucoma surgery. Jpn J Ophthalmol 57, 514–519 (2013). https://doi.org/10.1007/s10384-013-0257-5

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  • DOI: https://doi.org/10.1007/s10384-013-0257-5

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