Trabeculectomy with beta radiation: long-term follow-up

Ophthalmology. 2003 Sep;110(9):1822-6. doi: 10.1016/S0161-6420(03)00561-X.

Abstract

Purpose: To evaluate the long-term outcome and complications of trabeculectomy with beta radiation.

Design: Retrospective noncomparative case series.

Participants: Forty-three patients with confirmed primary open-angle glaucoma (POAG), who received trabeculectomy with adjunctive beta radiation at the Prince of Wales Hospital between June 1991 and November 1994.

Methods: Patients fulfilling the preceding criteria were followed up longitudinally. The visual acuity, intraocular pressure (IOP), bleb morphology, and complications were evaluated.

Main outcome measures: Visual acuity, IOP, bleb morphology, complications.

Results: Forty-three eyes of 43 consecutive Chinese patients were recruited and successfully followed up for a minimum of 7 years. The mean age +/- 1 standard deviation (SD) was 60.9 +/- 13.0 years. There were 29 males and 14 females. The mean baseline IOP +/- 1 SD was 28.3 +/- 5.8 mmHg. The mean postoperative IOP +/- 1 SD after the initial trabeculectomy was 11.9 +/- 4.3 mmHg, and the mean number of preoperative IOP-lowering eyedrops +/- 1 SD was reduced from 2.8 +/- 0.5 to 0.7 +/- 1.0 at 7 years follow-up. The qualified success rate at 7 years follow-up, defined as IOP <or=21 mmHg with and without medication(s), was 88.4%. The complete success rate at 7 years defined as IOP <or=21 mmHg without medication was 60.7%. Two eyes developed blebitis, and one of them progressed to corneal decompensation after the infection. One eye had hypotony, and one eye had a traumatic ruptured bleb. Twelve eyes (27.9%) developed significant cataract. No corneal ulceration or scleral necrosis was encountered.

Conclusions: From this noncomparative study, trabeculectomy with a single dose of 1000 rad beta radiation used as an adjunctive measure for POAG in Chinese eyes had achieved a qualified success rate of 88.4% at 7 years.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People
  • Beta Particles
  • Female
  • Follow-Up Studies
  • Glaucoma, Open-Angle / ethnology
  • Glaucoma, Open-Angle / radiotherapy*
  • Glaucoma, Open-Angle / surgery*
  • Hong Kong / epidemiology
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Strontium Radioisotopes / therapeutic use*
  • Trabecular Meshwork / radiation effects
  • Trabecular Meshwork / surgery
  • Trabeculectomy / methods*
  • Treatment Outcome
  • Visual Acuity
  • Visual Fields

Substances

  • Strontium Radioisotopes