Outcome of consecutive trabeculectomy.
OBJECTIVE
To establish a criterion for success of primary phakic trabeculectomy in the second eye of the same patient, using the first operated eye as a predictor for the surgical outcome.


METHODS
The outcome of primary phakic trabeculectomy was retrospectively compared in both eyes of 23 patients. Sixteen patients were treated with antimetabolites and seven were not. Postoperative intraocular pressure and number of glaucoma medications in paired eyes of the same patients were compared. Surgical success was defined as postoperative IOP of <20 mmHg without medication. Bleb morphology and the number of glaucoma medications were also compared in both eyes.


RESULTS
There was a positive correlation between the two eyes of a patient in the IOP values at each postoperative time point in both groups (with and without antimetabolites) (P > 0.05). At the last follow-up visit after trabeculectomy, the number of glaucoma medications used in paired eyes were not significantly different (P > 0.83). Surgical failure occurred more often in paired eyes than in single eyes. Bilateral failure occurred in 60% (3/5) of the failed trabeculectomies with antimetabolites and in 100% (3/3) of the failed trabeculectomies without antimetabolites.


CONCLUSIONS
Trabeculectomy outcome in paired eyes of patients was similar in both antimetabolites treated and untreated eyes. Thus, trabeculectomy outcome in the first operated eye can predict the surgical result in the second eye of the same patient.
Zalish
Miriam
M
Department of Ophthalmology, Kaplan Medical Center, Rehovot, and Hebrew University-Hadassah Medical School, Jerusalem, Israel. zalishm@yahoo.com
Oron
Yoram
Y
Geyer
Orna
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000963:Antimetabolites / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D012189:Retrospective Studies; D012590:Sclera / Q000187:drug effects; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
D000963:Antimetabolites; D016685:Mitomycin; D005472:Fluorouracil