Long-term follow-up of initially successful trabeculectomy.
OBJECTIVE
The purpose was to study the long-term outcomes of primary trabeculectomies that were successful at 1 year.


METHODS
A retrospective study of patients with various types of glaucoma who had trabeculectomies that were successful at 1 year and who had a follow-up of at least 10 years.


METHODS
There were 40 patients (40 eyes) who had primary trabeculectomies that were successful at 1 year and who had a follow-up range of 10 to 21 years.


METHODS
Control of intraocular pressure (IOP) and disease progression was evaluated at 5, 10, and 15 years and at the last obtainable follow-up.


METHODS
Successful control of IOP was defined as IOP less than 21 mmHg or a reduction of 33% if preoperative IOP was less than 21 mmHg. Successful control of disease progression was defined as stable cup-disc ratios determined by examination, or color photographs or both, as well as stable visual fields.


RESULTS
If an eye was considered successful by IOP at 1 year, the probability of successful control of IOP was 82% at 5 years and 67% at 10 and 15 years. If an eye was considered successful by IOP at 1 year, the probability of successful control of disease progression at 5 years was 77%, at 10 years 61%, and at 15 years 48%. If an eye did not require further glaucoma surgery at 1 year, the probability that it still would not need further surgery at 5 years was 90%, at 10 years 75%, and at 15 years 67%. Forty percent of eyes had cataract extraction by the time of last follow-up examination.


CONCLUSIONS
Loss of IOP control and progression of glaucomatous damage occurs over time despite initial success at 1 year.
Chen
T C
TC
University of Illinois at Chicago Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, USA.
Wilensky
J T
JT
Viana
M A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002387:Cataract Extraction; D002648:Child; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity