Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma

Anca Pantalon,1 Crenguta Feraru,2 Filip Tarcoveanu,2,3 Dorin Chiselita1,2 1Ophthalmology Clinic, St. Spiridon Emergency University Hospital, Iași, Romania; 2Ophthalmology Department, Gr. T. Popa University of Medicine and Pharmacy, Iași, Romania; 3Ophthalmology Department, Countess of Chester Hospit...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Pantalon A, Feraru C, Tarcoveanu F, Chiselita D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	trabeculectomy long term success advanced open angle glaucoma Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/06363d9e2ded458e8756f87f073d00c3
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:06363d9e2ded458e8756f87f073d00c3
record_format	dspace
spelling	oai:doaj.org-article:06363d9e2ded458e8756f87f073d00c32021-12-02T15:55:04ZSuccess of Primary Trabeculectomy in Advanced Open Angle Glaucoma1177-5483https://doaj.org/article/06363d9e2ded458e8756f87f073d00c32021-05-01T00:00:00Zhttps://www.dovepress.com/success-of-primary-trabeculectomy-in-advanced-open-angle-glaucoma-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Anca Pantalon,1 Crenguta Feraru,2 Filip Tarcoveanu,2,3 Dorin Chiselita1,2 1Ophthalmology Clinic, St. Spiridon Emergency University Hospital, Iași, Romania; 2Ophthalmology Department, Gr. T. Popa University of Medicine and Pharmacy, Iași, Romania; 3Ophthalmology Department, Countess of Chester Hospital NHS Trust, Chester, UKCorrespondence: Anca PantalonOphthalmology Clinic, St. Spiridon University Hospital, Iași, RomaniaTel +40740686865Email anca_pantalon@yahoo.comCrenguta FeraruOphthalmology Department, Gr. T. Popa University of Medicine and Pharmacy, Iași, RomaniaTel +40722752677Email crengi@yahoo.comAim: The study assesed trabeculectomy survival in advanced open angle glaucoma (OAG).Methods: This is a retrospective longitudinal study in advanced OAG undergoing primary trabeculectomy. Clinical and demographic parameters were recorded. Surgical survival (qualified/complete) was calculated by Kaplan–Meier analysis for multiple upper limits of intraocular pressure (IOP) with/without medication (≤ 21 mmHg, ≤ 18 mmHg, ≤ 15 mmHg, ≤ 12 mmHg); Cox hazard ratio analysis identified parameters influencing survival.Results: We included 165 eyes from 165 OAG patients: primary forms (POAG) – 86 eyes and secondary (pseudoexfoliative, SOAG) – 79 eyes; mean follow-up interval was 36.21 ± 13.49 months. Clinical parameters were comparable between sub-groups at baseline, except a higher IOP in SOAG vs POAG (36.6 ± 13.2 vs 32.7 ± 11.1 mmHg, p = 0.04); IOP reduction was similar (SOAG vs POAG) 53.93% vs 56.19%, p = 0.45, yet longer hospitalization (8.47 ± 4.39 (SOAG) vs 6.69 ± 3.01 days (POAG), p=0.03) and more medications (0.65 ± 0.24 vs 0.36 ± 0.16, p = 0.05) were needed to achieve comparable final IOP (16.0 ± 9.1 vs 15.1 ± 7.8 mmHg, p = 0.45). Kaplan Meier survival analysis applied for IOP ≤ 21 mmHg, ≤ 18 mmHg, ≤ 15 mmHg and ≤ 12 mmHg, revealed complete success in 26.2%, 27.3%, 34.5% and 54.6% eyes, respectively; qualified success was found in 45.7%, 48.6%, 77% and 88.6% eyes, respectively. Multiple medications at baseline diminished survival in all tested models (hazard ratio HR > 1, p< 0.05), while 5FU+needling improved survival, mostly if combined with lower IOP regime: HR = 0.15, 95% CI = [0.07 − 1.12], p = 0.06, if IOP ≤ 15 mmHg and HR = 0.09, 95% CI = [0.02– 1.25], p = 0.06, if IOP ≤ 12 mmHg.Conclusion: Trabeculectomy in advanced OAG reached very good survival rates (77% and 88.6%) at 36 months postoperative, if IOP could be maintained ≤ 15 mmHg, respectively ≤ 12 mmHg with medication and additional needling+5FU maneuvers. Specific factors influencing survival were identified for each success definition.Keywords: trabeculectomy, long term success, advanced open angle glaucomaPantalon AFeraru CTarcoveanu FChiselita DDove Medical Pressarticletrabeculectomylong term successadvanced open angle glaucomaOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 2219-2229 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	trabeculectomy long term success advanced open angle glaucoma Ophthalmology RE1-994
spellingShingle	trabeculectomy long term success advanced open angle glaucoma Ophthalmology RE1-994 Pantalon A Feraru C Tarcoveanu F Chiselita D Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma
description	Anca Pantalon,1 Crenguta Feraru,2 Filip Tarcoveanu,2,3 Dorin Chiselita1,2 1Ophthalmology Clinic, St. Spiridon Emergency University Hospital, Iași, Romania; 2Ophthalmology Department, Gr. T. Popa University of Medicine and Pharmacy, Iași, Romania; 3Ophthalmology Department, Countess of Chester Hospital NHS Trust, Chester, UKCorrespondence: Anca PantalonOphthalmology Clinic, St. Spiridon University Hospital, Iași, RomaniaTel +40740686865Email anca_pantalon@yahoo.comCrenguta FeraruOphthalmology Department, Gr. T. Popa University of Medicine and Pharmacy, Iași, RomaniaTel +40722752677Email crengi@yahoo.comAim: The study assesed trabeculectomy survival in advanced open angle glaucoma (OAG).Methods: This is a retrospective longitudinal study in advanced OAG undergoing primary trabeculectomy. Clinical and demographic parameters were recorded. Surgical survival (qualified/complete) was calculated by Kaplan–Meier analysis for multiple upper limits of intraocular pressure (IOP) with/without medication (≤ 21 mmHg, ≤ 18 mmHg, ≤ 15 mmHg, ≤ 12 mmHg); Cox hazard ratio analysis identified parameters influencing survival.Results: We included 165 eyes from 165 OAG patients: primary forms (POAG) – 86 eyes and secondary (pseudoexfoliative, SOAG) – 79 eyes; mean follow-up interval was 36.21 ± 13.49 months. Clinical parameters were comparable between sub-groups at baseline, except a higher IOP in SOAG vs POAG (36.6 ± 13.2 vs 32.7 ± 11.1 mmHg, p = 0.04); IOP reduction was similar (SOAG vs POAG) 53.93% vs 56.19%, p = 0.45, yet longer hospitalization (8.47 ± 4.39 (SOAG) vs 6.69 ± 3.01 days (POAG), p=0.03) and more medications (0.65 ± 0.24 vs 0.36 ± 0.16, p = 0.05) were needed to achieve comparable final IOP (16.0 ± 9.1 vs 15.1 ± 7.8 mmHg, p = 0.45). Kaplan Meier survival analysis applied for IOP ≤ 21 mmHg, ≤ 18 mmHg, ≤ 15 mmHg and ≤ 12 mmHg, revealed complete success in 26.2%, 27.3%, 34.5% and 54.6% eyes, respectively; qualified success was found in 45.7%, 48.6%, 77% and 88.6% eyes, respectively. Multiple medications at baseline diminished survival in all tested models (hazard ratio HR > 1, p< 0.05), while 5FU+needling improved survival, mostly if combined with lower IOP regime: HR = 0.15, 95% CI = [0.07 − 1.12], p = 0.06, if IOP ≤ 15 mmHg and HR = 0.09, 95% CI = [0.02– 1.25], p = 0.06, if IOP ≤ 12 mmHg.Conclusion: Trabeculectomy in advanced OAG reached very good survival rates (77% and 88.6%) at 36 months postoperative, if IOP could be maintained ≤ 15 mmHg, respectively ≤ 12 mmHg with medication and additional needling+5FU maneuvers. Specific factors influencing survival were identified for each success definition.Keywords: trabeculectomy, long term success, advanced open angle glaucoma
format	article
author	Pantalon A Feraru C Tarcoveanu F Chiselita D
author_facet	Pantalon A Feraru C Tarcoveanu F Chiselita D
author_sort	Pantalon A
title	Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma
title_short	Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma
title_full	Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma
title_fullStr	Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma
title_full_unstemmed	Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma
title_sort	success of primary trabeculectomy in advanced open angle glaucoma
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/06363d9e2ded458e8756f87f073d00c3
work_keys_str_mv	AT pantalona successofprimarytrabeculectomyinadvancedopenangleglaucoma AT feraruc successofprimarytrabeculectomyinadvancedopenangleglaucoma AT tarcoveanuf successofprimarytrabeculectomyinadvancedopenangleglaucoma AT chiselitad successofprimarytrabeculectomyinadvancedopenangleglaucoma
_version_	1718385430575972352

Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma

Ejemplares similares