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Success of trabeculectomy surgery in relation to cataract surgery: 5-year outcomes
  1. Rashmi G Mathew1,
  2. Sahar Parvizi2,
  3. Ian E Murdoch3
  1. 1 Department of Glaucoma, Moorfields Eye Hospital NHSFT, London, UK
  2. 2 Department of glaucoma, Moorfields Eye Hospital NHSFT, London, UK
  3. 3 Department of Epidemiology and International Eye Health, Institute of Ophthalmology, London, UK
  1. Correspondence to Rashmi G Mathew, Department of Glaucoma, Moorfields Eye Hospital NHSFT, London EC1v 2PD, UK; rashmi.mathew1{at}nhs.net

Abstract

Aims To compare success proportions at 5 years in three surgical groups: group 1, trabeculectomy alone; group 2, trabeculectomy followed by cataract surgery within 2 years; and group 3, trabeculectomy performed on a pseudophakic eye.

Methods A retrospective cohort study. 194 eyes of 194 patients were identified with at least 5 years’ follow-up post trabeculectomy (N=85, 60 and 49 in groups 1, 2 and 3, respectively).

Main outcome measures 1. Primary outcome measure: intraocular pressure (IOP) at 5 years post-trabeculectomy surgery, 2.Secondary outcome measure: change in visual acuity at 5 years.

Results At 5 years, the mean IOP (SD) was 12.9 (3.5), 12.5 (4.8) and 12.7 (4.8) mm Hg in groups 1, 2 and 3, respectively. Overall success was almost identical, 58%, 57% and 59% in groups 1, 2 and 3, respectively. There was no significant difference between the groups in terms of percentage IOP reduction, number of medications, proportion restarting medication and reoperation rates at 5 years. Logistic regression for an outcome of failure showed men to be at increased risk of failure OR 1.97 (95% CI 1.10 to 3.52, p=0.02). Nearly 80% of patients retained or improved their vision following their initial trabeculectomy.

Conclusions The sequence in which surgery is carried out does not appear to affect trabeculectomy function at 5 years, success being similar to trabeculectomy alone. In our study, men may be at increased risk of failure.

  • glaucoma
  • treatment surgery
  • wound healing

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Footnotes

  • Contributors RGM: planning the study, data analysis, writing first draft and finalisation of manuscript. SP: data collection, data analysis and writing first draft. IEM: planning the study, data analysis, writing first draft and finalisation of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the Clinical Audit unit, research and development department at Moorfields Eye Hospital. Analyses of this type do not require individual ethical permission as they are viewed as audit (see http://www.hra.nhs.uk/research-community/before-you-apply/determine-whether-your-study-is-research/).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no additional unpublished data from the study.

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