Effect of trabeculectomy on lens opacities in an East Asian population.
OBJECTIVE
To examine the progression of lens opacity in Asian people after trabeculectomy and determine associated risk factors.


METHODS
This was an observational case series of 243 people aged 36 to 82 years. Trabeculectomy was performed on 1 eye of each subject. Lens opacity was measured yearly using the Lens Opacification Classification System III. The main outcome measure was worsening of lens opacity defined as an increase of 2 or more Lens Opacification Classification System III units in any of the 3 lens regions, nuclear, cortical, and posterior subcapsular. Risk of progression was evaluated using logistic regression models.


RESULTS
Data for 177 people were analyzed. One hundred seventeen (66%) of 177 subjects showed progression in opacity in any lens region at 3 years. Seventy-seven (66%) of 117 of those who progressed did so during the first year. Of these, 63 (82%) of 77 had lens opacity in the posterior subcapsular region. Factors associated with progression of posterior-subcapsular lens opacity at 1 year were diabetes (odds ratio, 2.4; 95% confidence interval, 1.0-5.4), use of antiglaucoma medication, dosage of topical steroid postoperatively, and being operated on by a trainee surgeon (odds ratio, 2.3; 95% confidence interval, 1.0-5.2).


CONCLUSIONS
Trabeculectomy is associated with progression of lens opacity predominantly in the posterior subcapsular region. Modification of risk factors such as postoperative steroid use may delay progression.
Husain
Rahat
R
Institute of Ophthalmology, University College, London, England.
Aung
Tin
T
Gazzard
Gus
G
Foster
Paul J
PJ
Devereux
Joe G
JG
Chew
Paul T K
PT
Oen
Francis T S
FT
Khaw
Peng T
PT
Seah
Steve K L
SK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000963:Antimetabolites / Q000627:therapeutic use*; D002386:Cataract / Q000503:physiopathology*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007908:Lens, Crystalline / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D012846:Singapore; D014130:Trabeculectomy / Q000379:methods*
D000963:Antimetabolites; D005472:Fluorouracil