Dietary tocopherol supplementation after trabeculectomy and phacotrabeculectomy: double-blind randomized placebo-controlled trial.
OBJECTIVE
The vitamin E compound alpha-tocopherol inhibits fibroblast growth in vitro. To evaluate its potential benefit in preventing failure of glaucoma filtration surgery, we prospectively investigated the outcome of filtering surgery with postoperative dietary alpha-tocopherol supplementation.


METHODS
Thirty-nine patients (39 eyes) with primary open-angle glaucoma or pseudoexfoliative glaucoma were randomly assigned to two post-(phaco)-trabeculectomy treatment groups. Daily oral intake of 300 mg alpha-tocopheryl-acetate (absorbed as alpha-tocopherol in the intestine) for 2 months was compared to a placebo preparation in a double-blind trial. The follow-up time was 1 year. Success was defined as intraocular pressure (IOP) <or=18 mm Hg with no medication, no needling revision, and no subconjunctival injection.


RESULTS
In the tocopherol group, the relative risk for trabeculectomy failure decreased from 1.58 at 2 weeks (p = 0.95) to 1.0 at 1 year. Success rates (67-90%) and IOP reduction (mean 39 to 53%) were statistically comparable in the two groups. Considering postoperative complications, no relevant differences were found.


CONCLUSIONS
Trabeculectomy and phacotrabeculectomy outcome did not show any differences between alpha-tocopherol-supplemented patients and the placebo group.
Goldblum
David
D
Department of Ophthalmology, University of Bern, Inselspital, Bern, Switzerland. dgoldblum@uhbs.ch
Meyenberg
Alexander
A
Mojon
Daniel
D
Tappeiner
Christoph
C
Frueh
Beatrice E
BE
D000368:Aged; D002386:Cataract / Q000150:complications*; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage; D024502:alpha-Tocopherol / Q000008:administration & dosage*
D014815:Vitamins; D024502:alpha-Tocopherol