Prognostic factors in trabeculectomy with mitomycin C having history of previous glaucoma surgery

Jpn J Ophthalmol. 2013 Nov;57(6):514-9. doi: 10.1007/s10384-013-0257-5. Epub 2013 Aug 3.

Abstract

Purpose: To evaluate the prognostic factors for surgical outcomes of subsequent trabeculectomy with mitomycin C (MMC) after prior incisional glaucoma surgery.

Methods: We reviewed medical records of a total cohort of 781 trabeculectomies with MMC, and selected 125 patients (125 eyes). The primary endpoints included persistent intraocular pressure (IOP) of ≥21 or <5 mmHg, the need for additional glaucoma surgery and deterioration of visual acuity to no light perception. Univariate and Multivariate analyses were performed by using the Cox proportional hazards model.

Results: The mean follow-up period was 26.8 months. The probabilities of success at 1, 2, and 3 years were 80.6, 72.2, and 70.6 %, respectively. Multivariate analysis showed that a shorter time interval between prior glaucoma surgery and subsequent trabeculectomy [relative risk (RR), 0.8867/year; P = 0.0090] and the number of prior trabeculectomies (RR, 2.2645; P = 0.0029) were significant prognostic factors for subsequent failure of trabeculectomy with MMC.

Conclusion: A short time period between prior glaucoma surgery and subsequent trabeculectomy and the number of prior trabeculectomies are associated with surgical failure of subsequent trabeculectomy with MMC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alkylating Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Female
  • Glaucoma / diagnosis
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Infant
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Tonometry, Ocular
  • Trabeculectomy*
  • Treatment Failure
  • Visual Acuity / physiology

Substances

  • Alkylating Agents
  • Mitomycin