title: Complications and outcomes of primary phacotrabeculectomy with mitomycin C in a multi-ethnic asian population.
abstract: OBJECTIVE
  To determine the occurrence of intraoperative and postoperative complications up to three years after primary phacotrabeculectomy with intraoperative use of Mitomycin C (MMC) in primary open angle (POAG) and primary angle closure glaucoma (PACG) patients, and the effect of postoperative complications on surgical outcome.
  
  
  METHODS
  Retrospective review of 160 consecutive patients with POAG (n = 105) and PACG (n = 55), who underwent primary phacotrabeculectomy with MMC at the National University Hospital, Singapore, from January 1, 2008 to December 31, 2010. Data was collected using a standardized form that included patient demographic information, ocular characteristics and postoperative complications, including hypotony (defined as intraocular pressure < 6 mmHg), shallow anterior chamber (AC) and hyphema.
  
  
  RESULTS
  The mean age ± standard deviation (SD) of patients was 68.2 ± 8.2 years. No patient lost light perception during duration of follow-up. 77% of the postoperative complications occurred within the first month only. The commonest complications were hypotony (n = 41, 25.6%), hyphema (n = 16, 10.0%) and shallow AC (n = 16, 10.0%). Five patients (3.1%) required reoperation for their complications. Early hypotony (defined as hypotony < 30 days postoperatively) was an independent risk factor for surgical failure (hazard ratio [HR], 5.1; 95% CI, 1.6-16.2; p = 0.01). Hypotony with another complication was also a risk factor for surgical failure (p < 0.02).
  
  
  CONCLUSIONS
  Hypotony, hyphema and shallow AC were the commonest postoperative complications in POAG and PACG patients after phacotrabeculectomy with MMC. Most complications were transient and self-limiting. Early hypotony within the first month was a significant risk factor for surgical failure.
authors.affiliation: Department of Ophthalmology, National University Health System, Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: David Z
authors.initials: DZ
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, National University Health System, Singapore, Singapore.
authors.forename: Victor
authors.initials: V
authors.lastname: Koh
authors.affiliation: Department of Ophthalmology, National University Health System, Singapore, Singapore.
authors.forename: Chelvin
authors.initials: C
authors.lastname: Sng
authors.affiliation: Department of Ophthalmology, National University Health System, Singapore, Singapore.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Aquino
authors.affiliation: Department of Ophthalmology, National University Health System, Singapore, Singapore.
authors.forename: Paul
authors.initials: P
authors.lastname: Chew
mesh_terms: D000368:Aged; D044466:Asian People; D002386:Cataract / Q000208:ethnology / Q000628:therapy; D002387:Cataract Extraction / Q000379:methods; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000208:ethnology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000208:ethnology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000188:drug therapy; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D016685:Mitomycin