title: Medium-term outcomes of safe surgery system trabeculectomies.
abstract: OBJECTIVE
  To assess the safety and success of Safe Surgery System trabeculectomy beyond 3 years.
  
  
  METHODS
  Consecutive case series of 39 eyes in 32 patients. Trabeculectomy was performed using fornix-based conjunctival flap, standard trabeculectomy punch, adjustable scleral flap sutures and antimetabolite treatment. Primary outcome of surgical failure was defined by two criteria: (A) need for further surgery, glaucoma medications or an intraocular pressure (IOP) >21 mm Hg during >10% of follow-up; or (B) IOP >15 mm Hg for >10% follow-up. A relatively aggressive regime of bleb needling and subconjunctival injections was used postoperatively in an attempt to reduce bleb fibrosis and failure. The mean follow-up was 42 months (range 25-55).
  
  
  RESULTS
  The rate of surgical failure was 4.4% per eye-year for criterion A, and 8.0% per eye-year for criterion B. Complications were few and compared favourably with other published series.
  
  
  CONCLUSIONS
  The Safe Surgery System for trabeculectomy provides excellent IOP control both during the operation and in the short and medium term postoperatively, with few complications or surgical failures.
authors.affiliation: Ophthalmology Department, Capital & Coast District Health Board, Wellington, New Zealand.
authors.forename: J
authors.initials: J
authors.lastname: Gale
authors.forename: A P
authors.initials: AP
authors.lastname: Wells
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001768:Blister / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D013536:Suture Techniques; D014130:Trabeculectomy / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology