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Is post-trabeculectomy hypotony a risk factor for subsequent failure? A case control study

Benson, SE; Mandal, K; Bunce, CV; Fraser, SG; (2005) Is post-trabeculectomy hypotony a risk factor for subsequent failure? A case control study. BMC Ophthalmology , 5 , Article 7. 10.1186/1471-2415-5-7. Green open access

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Abstract

Background: Ocular hypotony results in an increased break down of the blood-aqueous barrier and an increase in inflammatory mediator release. We postulate that this release may lead to an increased risk of trabeculectomy failure through increased bleb scarring. This study was designed to try to address the question if hypotony within one month of trabeculectomy for Primary Open Angle Glaucoma (POAG), is a risk factor for future failure of the filter. Methods: We performed a retrospective, case notes review, of patients who underwent trabeculectomy for POAG between Jan 1995 and Jan 1996 at our hospital. We identified those with postoperative hypotony within 1 month of surgery. Hypotony was defined as an intraocular pressure (IOP) < 8 mmHg or an IOP of less than 10 mmHg with choroidal detachment or a shallow anterior chamber. We compared the survival times of the surgery in this group with a control group (who did not suffer hypotony as described above), over a 5 year period. Failure of trabeculectomy was defined as IOP > 21 mmHg, or commencement of topical antihypertensives or repeat surgery. Results: 97 cases matched our inclusion criteria, of these 38 (39%) experienced hypotony within 1 month of surgery. We compared the survival times in those patients who developed hypotony with those who did not using the log-rank test. This data provided evidence of a difference (P = 0.0492) with patients in the hypotony group failing more rapidly than the control group. Conclusion: Early post-trabeculectomy hypotony (within 1 month) is associated with reduced survival time of blebs.

Type: Article
Title: Is post-trabeculectomy hypotony a risk factor for subsequent failure? A case control study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/1471-2415-5-7
Publisher version: http://dx.doi.org/10.1186/1471-2415-5-7
Language: English
Additional information: © 2005 Benson et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/1320311
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