Surgical management of post-traumatic angle recession glaucoma.
OBJECTIVE
The purpose of this study is to compare the results of three different drainage procedures performed for uncontrolled post-traumatic angle recession glaucoma.


METHODS
A retrospective analysis was undertaken of 87 drainage procedures performed on 65 patients over an 8-year period. The results of trabeculectomy (47 procedures), Molteno single-plate implantation (20 procedures), and trabeculectomy combined with antimetabolite (20 procedures) were compared. Of those treated with antimetabolite, 11 received postoperative subconjunctival injections of 5-fluorouracil and 9 received an intraoperative application of 0.02% mitomycin C to the trabeculectomy site.


RESULTS
In the group undergoing trabeculectomy with antimetabolite therapy, the intraocular pressure (IOP) drop was significantly greater, the percentage of successful cases at 3 and 6 months postoperatively was significantly higher, and the number of postoperative glaucoma medications was significantly lower than the other two groups. No statistically significant differences were found between the groups undergoing trabeculectomy without antimetabolite therapy and Molteno implantation. Of concern were three cases of late bleb infection in the group that received postoperative antimetabolite therapy.


CONCLUSIONS
In medically uncontrolled post-traumatic angle recession glaucoma, trabeculectomy with antimetabolite therapy is the most effective surgical procedure. However, late bleb infection is a significant risk.
Ophthalmology Department, Groote Schuur Hospital, Observatory, South Africa.
A
A
Mermoud
J F
JF
Salmon
A
A
Barron
C
C
Straker
A D
AD
Murray
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000293:injuries; D002648:Child; D003131:Combined Modality Therapy; D004322:Drainage; D005131:Eye Injuries / Q000150:complications / Q000601:surgery*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D011183:Postoperative Complications; D019736:Prostheses and Implants; D012189:Retrospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome
D016685:Mitomycin; D005472:Fluorouracil