title: Prognostic factors for trabeculectomy failure in a Cuban population.
abstract: OBJECTIVE
  To identify the prognostic factors for mid-term trabeculectomy failure.
  
  
  METHODS
  A prospective cohort study was conducted on 113 eyes (113 patients) that had undergone a trabeculectomy for primary open or closed angle, pigmentary, or juvenile glaucoma. Surgical failure was defined if intraocular pressure was equal or more than 18mmHg with medication (two or more drops), after 1-4 postoperative years. The relative risk was calculated and a logistic regression analysis was performed.
  
  
  RESULTS
  Previous trabeculectomy, preoperative intraocular pressure ≥ 31mmHg, black race, and advanced glaucoma increased the failure risk by 7.9 times (P=.036), 5.3 times (P=.011) and 4.7 times (P=.028, and P=.027), respectively. The addition of two or more factors increased the risk by 6.4 times (P<.001). It was not affected by age, sex, pre-operative drops, or surgical complication.
  
  
  CONCLUSIONS
  Previous trabeculectomy, pre-operative intraocular pressure ≥ 31mmHg, black race, and advanced glaucoma are prognostic factors for trabeculectomy failure, in decreasing order of their association with surgical failure. The addition of two or more factors increased the risk of failure. In those situations, the use of trans- operative anti-metabolites is suggested.
authors.affiliation: Instituto Cubano de Oftalmología «Ramón Pando Ferrer», Departamento de Glaucoma, La Habana, Cuba. Electronic address: lianetfa@infomed.sld.cu.
authors.forename: L
authors.initials: L
authors.lastname: Fernández Argones
authors.affiliation: Instituto Cubano de Oftalmología «Ramón Pando Ferrer», Departamento de Glaucoma, La Habana, Cuba.
authors.forename: C M
authors.initials: CM
authors.lastname: Padilla González
authors.affiliation: Instituto Cubano de Oftalmología «Ramón Pando Ferrer», Departamento de Glaucoma, La Habana, Cuba.
authors.forename: I
authors.initials: I
authors.lastname: Obret Mendive
authors.affiliation: Instituto Cubano de Oftalmología «Ramón Pando Ferrer», Departamento de Glaucoma, La Habana, Cuba.
authors.forename: I
authors.initials: I
authors.lastname: Piloto Díaz
authors.affiliation: Instituto Cubano de Oftalmología «Ramón Pando Ferrer», Departamento de Glaucoma, La Habana, Cuba.
authors.forename: F Y
authors.initials: FY
authors.lastname: Fumero González
mesh_terms: D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D014130:Trabeculectomy; D017211:Treatment Failure
keywords: Factores pronósticos; Fracaso quirúrgico; Glaucoma; Intraocular pressure; Presión intraocular; Prognostic factors; Surgical failure; Trabeculectomy; Trabeculectomía