Dataset Information

Relationship between age and surgical success after trabeculectomy with adjunctive mitomycin C.

ABSTRACT:

Purpose

To investigate whether there is any effect of age on bleb morphology and surgical success after trabeculectomy with adjunctive Mitomycin C (MMC).

Methods

A total 143 eyes of 123 patients were divided into two groups: group 1 (???60 years old, n?=?85) and group 2 (?>?60 years old, n?=?58). Kaplan-Meier survival curve analysis was used to assess long-term surgical success according to "complete success" (intraocular pressure (IOP) reduction???30% without medications) and "qualified success" criteria (IOP reduction???30%, with or without medications) between the two groups. Cox proportional hazard models were used to examine the factors associated with surgical success. Bleb morphology was evaluated by height, extent and vascularity at postoperative 1 month, 3 months, 6 months, and 12 months.

Results

The younger-age group (group 1) showed significantly better results, in terms of both complete success and qualified success, than did the older-age group (group 2) (p?ConclusionThe long-term surgical outcome after trabeculectomy with MMC was better in the younger-age group than in the older-age group. Specifically, the younger-age group showed a more prominent and more localized bleb with less vascularity.

SUBMITTER: Hoang TKH

PROVIDER: S-EPMC6085316 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

Relationship between age and surgical success after trabeculectomy with adjunctive mitomycin C.

Hoang Thi Kieu Hau TKH Kim Young Kook YK Jeoung Jin Wook JW Park Ki Ho KH

Eye (London, England) 20180327 8

<h4>Purpose</h4>To investigate whether there is any effect of age on bleb morphology and surgical success after trabeculectomy with adjunctive Mitomycin C (MMC).<h4>Methods</h4>A total 143 eyes of 123 patients were divided into two groups: group 1 ( ≤ 60 years old, n = 85) and group 2 ( > 60 years old, n = 58). Kaplan-Meier survival curve analysis was used to assess long-term surgical success according to "complete success" (intraocular pressure (IOP) reduction ≥ 30% without medications) and "qu ...[more]

PMID: 29581522

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Project description:Antifibrotic agents are commonly utilized to enhance the success rates of trabeculectomy. Novel approaches to further improve success rates and reduce the risks of complications are needed. The purpose of this study was to compare intraocular pressure (IOP)-lowering efficacy and safety of trabeculectomy or combined phacoemulsification and trabeculectomy with mitomycin-C (MMC) vs. Collagen Matrix (CM).A prospective, multicenter, randomized controlled trial was performed. Ninety-five eyes of 94 patients with uncontrolled glaucoma despite medical therapy, without previous incisional glaucoma surgery underwent trabeculectomy (85 eyes) or combined phacoemulsification and trabeculectomy (10 eyes) and were randomized to MMC or CM. One eye of each subject was analyzed. Patients were followed for 24 months. The criteria for complete success were IOP >5 and ?21 mmHg with at least a 20% reduction below medicated baseline without additional glaucoma surgery or medications. The main outcome measures were complete success rates at 24 months with Kaplan-Meier analysis and incidence of adverse events.The baseline IOPs were 20.4?±?6.0 mmHg and 21.2?±?6.1 (mean?±?standard deviation, p?=?0.49) on 3.2?±?1.1 and 3.1?±?1.0 medications (p?=?0.53) compared to 11.8?±?5.2 and 12.8?±?3.7 (p?=?0.36) on 0.5?±?0.8 and 0.6?±?1.0 medications (p?=?0.63) at 2 years in the MMC and CM groups, respectively. Kaplan-Meier analysis demonstrated complete success rates were similar in both groups at 24 months: 38.4?±?7.6% with MMC and 56.2?±?7.9% with CM (mean?±?standard error, p?=?0.112, log rank test); however, a significantly higher incidence of failure due to persistent hypotony was observed with MMC (p?=?0.002).Use of the CM implant at the time of trabeculectomy or combined phacoemulsification and trabeculectomy is associated with similar complete success rates compared to adjunctive MMC; however, the risk of persistent hypotony is higher with MMC.ClinicalTrials.gov registration number NCT01440751 . Registered 9/14/11.

Dataset Information

Relationship between age and surgical success after trabeculectomy with adjunctive mitomycin C.

Purpose

Methods

Results

Publications

Relationship between age and surgical success after trabeculectomy with adjunctive mitomycin C.

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