Can early postoperative intraocular pressure predict success following mitomycin-C augmented trabeculectomy in primary angle-closure glaucoma

Rong, S. S., Feng, M. Y., Wang, N., Meng, H., Thomas, R., Fan, S., Wang, R., Wang, X., Tang, X. and Liang, Y. B. (2013) Can early postoperative intraocular pressure predict success following mitomycin-C augmented trabeculectomy in primary angle-closure glaucoma. Eye, 27 3: 403-409. doi:10.1038/eye.2012.291


Author Rong, S. S.
Feng, M. Y.
Wang, N.
Meng, H.
Thomas, R.
Fan, S.
Wang, R.
Wang, X.
Tang, X.
Liang, Y. B.
Title Can early postoperative intraocular pressure predict success following mitomycin-C augmented trabeculectomy in primary angle-closure glaucoma
Journal name Eye   Check publisher's open access policy
ISSN 0950-222X
1476-5454
Publication date 2013-03
Sub-type Article (original research)
DOI 10.1038/eye.2012.291
Volume 27
Issue 3
Start page 403
End page 409
Total pages 7
Place of publication London, United Kingdom
Publisher Nature Publishing Group
Collection year 2014
Language eng
Formatted abstract
Purpose:
To evaluate the association between early and late postoperative intraocular pressure (IOP) and determine if early postoperative IOP can predict the surgical outcome.

Methods:
A total of 165 consecutive patients with primary angle-closure glaucoma (PACG) undergoing primary mitomycin-C-augmented trabeculectomy underwent a comprehensive eye examination before surgery and were followed-up on days 1, 7, 14, and 30, and months 3, 6, 12, and 18. IOPs on days 1, 7, 14, and 30 were stratified into groups A (<10 mm Hg), B (≥10 and <15 mm Hg), C (≥15 and <20 mm Hg), and D (≥20 mm Hg). Differences between groups were analyzed using analysis of variance (ANOVA) and Fisher’s exact test. Multivariable regression was used to exam the predictive ability of early IOP for final outcome.

Results: The mean age was 62.5±7.9 years and 41.21% (n=68) were males. Stratified by IOP on days 1, 7, 14, and 30, respectively, mean IOPs at month 18 were different among groups A, B, C, and D (ANOVA, P=0.047, P=0.033, P=0.008, and P<0.001, respectively). Once the IOPs were settled with interventions on day 7 a higher IOP level was associated with decreasing success rate under different outcome definitions, final IOP <15 mm Hg (Fisher’s exact P=0.001) and <20 mm Hg (P=0.039) without medication. Multiple regression showed early IOP predicted final IOP independently from baseline variables. A cutoff value of 13.5 mm Hg on day 7 achieved an accuracy of 80.0 and 57.1% in predicting IOP<15 mm Hg without medication and failure after surgery, respectively.

Conclusions: The IOP at 18 months following primary antifibrotic-augmented trabeculectomy in PACG patients is associated with and predicted by the postoperative IOPs at 1 month. Control of early IOP to 13.5 or less may provide better outcomes.
Keyword Trabeculectomy
Intraocular pressure
Releasable sutures
Outcome prediction
Active bleb management
Angle-closure glaucoma
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 7 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 26 May 2013, 01:13:47 EST by System User on behalf of Scholarly Communication and Digitisation Service