title: Refusal of Trabeculectomy for the Fellow Eye in Collaborative Initial Glaucoma Treatment Study (CIGTS) Participants.
abstract: OBJECTIVE
  To understand the reasons for refusal of fellow eye surgical treatment for glaucoma after first eye trabeculectomy.
  
  
  METHODS
  Post hoc analysis of data collected in a multicenter, randomized clinical trial.
  
  
  METHODS
  Data from participants in the Collaborative Initial Glaucoma Treatment Study (CIGTS) who were randomized to and underwent initial trabeculectomy on their study eye, and whose fellow eye was eligible for surgical treatment, were analyzed. Participant demographic data and characteristics, surgical data from the study eye, and quality-of-life survey results were compared between groups that received or refused trabeculectomy in their fellow eye. The main outcome measure was patient refusal of fellow eye surgery for glaucoma.
  
  
  RESULTS
  Of 159 participants who were randomized to and underwent trabeculectomy on their study eye and had a fellow eye that was eligible for surgery, 30 (19%) refused fellow eye surgery. Eligible patients who refused fellow eye trabeculectomy did not differ significantly in visual function or local eye symptoms from those that underwent fellow eye trabeculectomy (all P > .05). In a multivariable analysis of data, increased fellow eye preoperative intraocular pressure (IOP) was associated with decreased odds (OR = 0.89, P = .0188), study eye hypotony at 3 months postoperatively was associated with increased odds (OR = 7.24, P = .0125), and argon suture lysis procedure was associated with decreased odds (OR = 0.38, P = .0385) of surgery refusal.
  
  
  CONCLUSIONS
  Refusal of fellow eye surgery was not uncommonly encountered in the CIGTS. Those who refused fellow eye surgery had lower fellow eye IOP and were more likely to have had hypotony after study eye trabeculectomy.
authors.affiliation: Duke Eye Center, Duke University Medical Center, Durham, North Carolina. Electronic address: divakar.gupta@duke.edu.
authors.forename: Divakar
authors.initials: D
authors.lastname: Gupta
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: David C
authors.initials: DC
authors.lastname: Musch
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Niziol
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle, Washington.
authors.forename: Philip P
authors.initials: PP
authors.lastname: Chen
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014130:Trabeculectomy; D016312:Treatment Refusal / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents