Trabeculectomy for acute primary angle closure☆
Section snippets
Patients and methods
A retrospective review was carried out on consecutive patients who underwent trabeculectomy for APAC at two tertiary referral hospitals in Singapore from 1993 through 1995 and who were observed for at least 6 months. Institutional Review Board approval was not required for this particular study because it was retrospective. There was a total of 56 eyes in 56 patients. The demographic characteristics are summarized in Table 1.
The following criteria were used to define cases of APAC.
- 1.
Presence of
Results
There were 56 eyes that underwent trabeculectomy for APAC. No patient had antimetabolite therapy. The mean followup period was 22 ± 10.7 months (range, 6–42 months).
The indication for trabeculectomy was as follows:
(n = 32 eyes): Medical failure group.
(n = 24 eyes): Medical success group but with signs of chronic angle-closure glaucoma. These were eyes with acute angle closure that responded to medication, and IOP decreased to less than 22 mmHg. However, the patients underwent
Discussion
Acute primary angle closure that is resistant to medical therapy is a serious therapeutic challenge in ophthalmology. There is an urgent need to relieve the acute pupillary block to minimize optic nerve damage, and this can be accomplished by laser or surgery. We have found that the success rate (in terms of IOP control) for trabeculectomy performed as an urgent surgical intervention in such medically uncontrolled APAC eyes (group A) was low, at only 56.2%. The incidence of postoperative
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The authors have no commercial interest in any of the material discussed in the paper.