[Trabeculectomy according to P. Khaw's protocol: medium-term tonometric results].
OBJECTIVE
P. Khaw has described a new trabeculectomy technique to enhance the reliability (fewer complications) and the efficacy of the classic trabeculectomy introduced by Cairns. The purpose of this study was to assess the medium-term tonometric results and complications of this new surgical procedure.


METHODS
and methods: In a retrospective and nonrandomized study, 26 consecutive eyes of 21 patients who underwent trabeculectomy according to P. Khaw's protocol were analyzed. The surgeon conducted postoperative care for the first 2 months. The minimal follow-up was 1 year, with a mean follow-up of 16.8 months (range, 12-18 months). The criteria for success were defined as intraocular pressure (IOP) less than 16 mmHg without treatment.


RESULTS
The mean IOP remained stable around 12 mmHg during the study follow-up: 12.5 mmHg+/-3.07 at 12 months and 11.8 mmHg+/-3.17 at 18 months. The success rate was 92.3% at 3 months and 84.6% at 6, 9, and 12 months. The mean IOP reduction was 44.1%+/-17.05. No failure was observed between months 6 and 18. The probability for an IOP under 16 mmHg without treatment at months 12 and 18 was 84% (Kaplan-Meier). At 1 year, 65% of the eyes had an IOP under 14 mmHg without treatment. Complications were limited and transient: one case of choroidal detachment and three cases of hyphema. No flat anterior chamber and no infection were observed during follow-up.


CONCLUSIONS
The new trabeculectomy described by P. Khaw is a promising procedure because at the medium term it provides tonometric results matching the target pressure of glaucomatous patients without the complications of the classic trabeculectomy.
Gruber
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Cabinet d'Ophtalmologie, Le Havre. denis.gruber@free.fr
D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008365:Manometry / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome