Trabeculectomy in patients with primary angle-closure glaucoma

J Glaucoma. 2009 Dec;18(9):679-83. doi: 10.1097/IJG.0b013e31819c4a07.

Abstract

Purpose: To analyze the results of trabeculectomy in patients with primary angle-closure glaucoma.

Methods: A retrospective and noncomparative case series analysis was performed on data from Taiwan, from 2001 to 2004. The outcomes of trabeculectomy in eyes with acute primary angle-closure glaucoma attack (AACG) and those with chronic primary angle-closure glaucoma (CACG) were assessed in terms of final intraocular pressure (IOP), changes to visual acuity, and the incidence of complications.

Results: A total of 52 eyes of 52 patients, 15 patients in AACG group and 37 patients in CACG group, were reviewed. The mean follow-up period was 32 months (range, 26-42 mo). In terms of no visual acuity change after surgery, there were significant differences between the CACG and AACG groups (P=0.02, Fisher exact test). In terms of final IOP control, trabeculectomy outcome was significantly worse in patients in the AACG group than those in the CACG group (P<0.01, Fisher exact test). Moreover, the complication of bleb encapsulation appeared more frequently in the AACG group than in the CACG group (P=0.02, Fisher exact test).

Conclusions: Compared with CACG, trabeculectomy may not be as good for patients of AACG, because it may lead to worsened visual acuity; it also seems to present a greater failure rate, more complications, and fewer cases of surgical survival.

MeSH terms

  • Acute Disease
  • Female
  • Glaucoma, Angle-Closure / physiopathology
  • Glaucoma, Angle-Closure / surgery*
  • Humans
  • Intraocular Pressure / physiology
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Tonometry, Ocular
  • Trabeculectomy*
  • Treatment Outcome
  • Visual Acuity / physiology