Intermediate-term comparison of trabeculectomy with intraoperative mitomycin-C between Asian American and Caucasian glaucoma patients: a case-controlled comparison.
OBJECTIVE
Compare the efficacy and survival of trabeculectomy with intraoperative mitomycin-C (MMC) between Asian American and Caucasian patients in the same clinical setting.


METHODS
In total, 29 Asian American patients (29 eyes) with trabeculectomies were matched case to case with 29 Caucasian patients (29 eyes) retrospectively. Matching criteria included age, glaucoma subtype, and preoperative intraocular pressure (IOP), gender, surgeon, ocular history, and glaucoma medications. Criteria of success included: (1) Final IOP>5 and <22 mmHg, (2) IOP reduction>or=20%, or final IOP<or=10 mmHg, and (3) without additional glaucoma surgery, loss of light perception, or complication.


RESULTS
Mean follow-up durations of Asian American and Caucasian group were 40.11+/-22.5 months and 38.8+/-17.7 months, respectively (P=0.81). At the final visits, IOP decreased from 18.7+/-6.1 to 10.9+/-4.0 mmHg (P<0.0001) in the Asian American group, and from 19.0+/-5.5 to 11.0+/-3.8 mmHg (P<0.0001) in the Caucasian group. There were no significant differences between the two groups in IOP levels at 6 months, 1 year, and final visits. The probabilities of trabeculectomy survival (continuing to meet definition of success criteria) at 12 and 48 months were 75.9 and 56.6% in the Asian American group and 82.8 and 66.6% in the Caucasian group, respectively. (P=0.46) There were no significant differences for rates of surgical success, failure, complication, vision decrease, hypotony, and cataract development. Patients who had episodes of hypotony had a higher rate of diagnosis of low-tension glaucoma subtype (P=0.02).


CONCLUSIONS
In a case-controlled comparison of an intermediate-term follow-up of trabeculectomy with intraoperative MMC, Asian American patients have a similar efficacy and survival probability as Caucasian patients.
Law
S K
SK
Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA. law@jsei.ucla.edu
Modjtahedi
S P
SP
Mansury
A
A
Caprioli
J
J
D000328:Adult; D000368:Aged; D001213:Asian; D003131:Combined Modality Therapy; D004812:Epidemiologic Methods; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000208:ethnology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D014130:Trabeculectomy; D017211:Treatment Failure; D016896:Treatment Outcome; D044465:White People
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin