title: ReGAE 9: baseline factors for success following augmented trabeculectomy with mitomycin C in African-Caribbean patients.
abstract: BACKGROUND
  To identify the baseline factors influencing success following trabeculectomy with mitomycin C in a case series of African-Caribbean patients.
  
  
  METHODS
  A prospective, observational and non-comparative cohort study.
  
  
  METHODS
  Forty-seven consecutive African-Caribbean patients (47 eyes) with glaucoma.
  
  
  METHODS
  Association between trabeculectomy survival and study factors was examined using Fisher's exact test and the Wilcoxon rank sum test at 12, 24 and 36 months following trabeculectomy. Logistic regression was used to establish the combination of factors best predicting survival.
  
  
  METHODS
  Surgical success was based upon intraocular pressure reduction to ≤21 mmHg, ≤18 mmHg and ≤15 mmHg without glaucoma medication (criterion 1), or intraocular pressure reduction to ≤21 mmHg, ≤18 mmHg and ≤15 mmHg with or without glaucoma medication (criterion 2).
  
  
  RESULTS
  Trabeculectomy survival at 36 months was significantly decreased with the use of preoperative acetazolamide, pseudophakic status and higher preoperative intraocular pressure (P < 0.05). In pseudophakic eyes, there was a lower rate of success for criterion 2 when aiming for an intraocular pressure ≤15 mmHg at 2 years post-trabeculectomy, the odds ratio being 12.
  
  
  CONCLUSIONS
  Three major independent risk factors were identified that influenced trabeculectomy failure at 3 years in African-Caribbean ethnicity: the preoperative use of acetazolamide, pseudophakic status and higher preoperative intraocular pressure. The presence of these risk factors may guide the clinician to use a more aggressive antiproliferative and postoperative management regime to enhance survival rates in this high-risk population.
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, UK.
authors.forename: Pavi
authors.initials: P
authors.lastname: Agrawal
authors.forename: Peter
authors.initials: P
authors.lastname: Shah
authors.forename: Victor
authors.initials: V
authors.lastname: Hu
authors.forename: Peng T
authors.initials: PT
authors.lastname: Khaw
authors.forename: Rodger
authors.initials: R
authors.lastname: Holder
authors.forename: Freda
authors.initials: F
authors.lastname: Sii
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044383:Black People / Q000208:ethnology*; D017691:Caribbean Region / Q000453:epidemiology; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000208:ethnology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011446:Prospective Studies; D012307:Risk Factors; D014130:Trabeculectomy; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000477:Alkylating Agents; D000959:Antihypertensive Agents; D016685:Mitomycin