Document Detail


Audit of trabeculectomy at a tertiary referral hospital in East Africa.
MedLine Citation:
PMID:  16276273     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To audit medium-term results of trabeculectomy at a tertiary referral unit in east Africa. METHODS: A retrospective review of the files of all patients who underwent trabeculectomy surgery at our hospital during the year 2001. RESULTS: One hundred fifty-seven patients were included. Mean age was 61 years (SD = 12). Thirty-one patients (20%) were women; 120 of 145 (83%) eyes had cup/disc ratios of 0.8 or greater preoperatively. Intraoperative 5-fluorouracil (5FU) was used in 57 cases (36%). Mean follow-up was 8 months (0-28, SD = 7). Mean intraocular pressures (IOP) was 25 mm Hg (6-70, SD = 10) preoperatively, 11 mm Hg (0-32, SD = 5) at 2 weeks postoperatively, and 13 mm Hg (0-42, SD = 6) at latest follow-up. One hundred fifteen patients (73%) had intraocular pressure of 15 mm Hg or less at latest follow-up and 141 (90%) had intraocular pressure of 21 mm Hg or less. Twenty (13%) had restarted antiglaucoma medication during the follow-up period. Thirty-seven of 148 (25%) lost 2 lines of Snellen acuity or equivalent between preoperative measurement and latest follow-up. Early postoperative complications (usually leaking bleb or shallow anterior chamber with hypotony) occurred in 18 patients (12%) and this was associated with postoperative loss of 2 or more lines of Snellen acuity (OR = 1.11 95% CI 1.02-1.22, P= 0.02). Patients having had 5FU had lower (t = 3.11, P= 0.02) mean intraocular pressure at 2-month follow-up (12 mm Hg, SD = 5) than those who did not receive it (16 mm Hg, SD = 6) but there was no significant difference at later follow-ups. Men (mean 14 mm Hg, SD = 6) had higher (t = 2.71, P= 0.01) intraocular pressures at latest follow-up than women (mean 11 mm Hg, SD = 3). CONCLUSIONS: The results of surgery compare well with other reported series. 5FU did not demonstrate significant benefit in terms of intraocular pressure lowering beyond 2 months postoperatively. Early postoperative hypotony should be avoided. The gender difference in intraocular pressure results has not previously been reported and deserves further investigation.
Authors:
Joy Kabiru; Richard Bowman; Mark Wood; Milka Mafwiri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of glaucoma     Volume:  14     ISSN:  1057-0829     ISO Abbreviation:  J. Glaucoma     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-08     Completed Date:  2005-12-20     Revised Date:  2006-11-03    
Medline Journal Info:
Nlm Unique ID:  9300903     Medline TA:  J Glaucoma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  432-4     Citation Subset:  IM    
Affiliation:
Comprehensive Community Based Rehabilitation for Tanzania Disability Hospital, Dar es Salaam, Tanzania.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antihypertensive Agents / therapeutic use
Antimetabolites / administration & dosage
Female
Fluorouracil / administration & dosage
Glaucoma / physiopathology,  surgery*
Humans
Intraocular Pressure / physiology
Male
Medical Audit*
Middle Aged
Postoperative Complications
Referral and Consultation
Retrospective Studies
Tanzania
Trabecular Meshwork / drug effects,  surgery*
Trabeculectomy / methods*
Visual Acuity / physiology
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Antimetabolites; 51-21-8/Fluorouracil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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