Aim: To assess safety and success of the safe surgery system trabeculectomy beyond three years.
Methods: Consecutive case series of 39 eyes in 32 patients. Trabeculectomy was performed using fornix based conjunctival flap, standard trabeculectomy punch, adjustable scleral flap sutures and antimetabolite treatment. Primary outcome of surgical failure was defined by two criteria: A) need for further surgery, glaucoma medications or an intraocular pressure (IOP) > 21mmHg during > 10% of follow up; or B) IOP > 15mmHg for > 10% follow up. A relatively aggressive regime of bleb needling and subconjunctival injections was used postoperatively in an attempt to reduce bleb fibrosis and failure. Mean follow up was 42 months (range 25-55).
Results: The rate of surgical failure was 4.4% per eye-year for criterion A, and 8.0% per eye-year for criterion B. Complications were few and compared favourably to other published series.
Conclusion: The safe surgery system for trabeculectomy provides excellent IOP control both during the operation and in the short and medium term postoperatively, with few complications or surgical failures.