Analysis of Early Failure after Trabeculectomy

ABSTRACT

PURPOSE: Among the patients with increased intraocular pressure (IOP) after primary trabeculectomy, we evaluated the factors which might influence the surgical results in early failure cases. METHOD: We retrospectively reviewed the charts of the patients who had undergone primary trabeculectomies. Surgical failures were defined as the eyes with the increased IOPs (> or =21 mmHg), and early failure cases were defined as the elevated IOP within 2 months after surgeries, and as late failures thereafter. The early failure cases were then divided into the recovery group (IOP was decreased by digital massages or releasable suture removals) and non-recovery group. RESULTS: Thirty-eight cases among 78 eyes experienced elevated IOPs during the mean follow-up period of 25.3 months, and 28 cases had experienced early failures. Among the early failure cases, 12 eyes belonged to the recovery group and 16 eyes to the non-recovery group. Sex, age, preoperative IOP, mitomycin C use, systemic diseases, types of glaucoma, triple surgeries, numbers of preoperative medications, and types of scleral flap were similar between the recovery and non-recovery groups. However, the mean failure time was shorter in the recovery group than in the non-recovery group (0.4 vs 1.0 months; p= 0.0017, t-test). CONCLUSIONS: Our results suggest that there is greater probability in recovery of increased IOP with earlier digital pressures or releasable suture removals for the early postoperative increased IOP than with the managements of the later postoperative increased IOP.