Age over 46 years does not affect the pressure lowering effect of trabeculectomy in primary open angle glaucoma
Tennent Institute of
Ophthalmology, Western Infirmary, Dumbarton Road, Glasgow G11 6NT
Correspondence to: Michael C Briggs, St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP.
Accepted for publication 30 September 1998
BACKGROUND/AIMS
Previous
reports have suggested that the success rate for trabeculectomy is
poorer in younger age groups but these studies often have heterogeneous
groups representing different types of glaucoma with variable surgical
prognosis. Therefore, the relation between age and the success of
trabeculectomy in the single diagnostic category of primary open angle
glaucoma (POAG) without identifiable risk factors was examined for
failure in the age range 46-85 years.
METHODSThe
records of 208 patients who had undergone a first trabeculectomy for
POAG were examined retrospectively. Age ranged from 46 to 85 (mean 66.7 years). The outcome of surgery was examined at final available follow
up and at 1 and 2 years after surgery. Trabeculectomy was considered a
success if intraocular pressure was 
21 mm Hg with or without
additional medical treatment ("cumulative" success) and an
"absolute" success if intraocular pressure was 21 mm Hg without
additional medical treatment.
RESULTSCumulative
success for trabeculectomy was 92.3% at final follow up and 96.6% at
2 year follow up; absolute success rate was 66.3% at final follow up
and 71.6% at 2 years. There was no significant trend for greater
success of trabeculectomy in the older age groups (cumulative success
at 2 year follow up, 
2 for linear trend 1.07(p=0.3) nor
was the drop in intraocular pressure following surgery significantly
greater with increasing age (analysis of variance for intraocular
pressure lowering from presentation to 2 years' follow up
(Kruskal-Wallis, t=5.9, p=0.55). Patients
with pseudoexfoliation were excluded from the main analysis as these
patients have been shown to have a lower final intraocular pressure
following trabeculectomy, a finding which was confirmed in this study.
CONCLUSIONThis study
demonstrates that in the age range 46-85 years there is no
demonstrable relation between age at the time of surgery and success of
trabeculectomy in POAG
© 1999 by British Journal of Ophthalmology
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