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Abstract #15614 Published in IGR 1-3
Risk factors for early filtration failure requiring suture release after primary glaucoma triple procedure with adjunctive mitomycin
Morris DA; Peracha MO; Shin DH; Kim C; Cha SC; Kim YYArchives of Ophthalmology 1999; 117: 1149-1154
PURPOSE: Postoperative release of scleral flap closure suture is useful in trabeculectomy combined with cataract surgery. The authors determined risk factors for early filtration failure requiring suture release during the first month after primary glaucoma triple procedure. METHODS: The medical records of 71 consecutive patients with primary open-angle glaucoma who underwent a primary glaucoma triple procedure (primary trabeculectomy, phacoemulsification, and posterior chamber intraocular lens implantation) were reviewed. Suture release had been performed in 24 of the patients for early filtration failure with postoperative intraocular pressure greater than the target value during the first postoperative month. The long-term filtration failure was defined according to two criteria based on medical dependency and requirement of additional surgical procedure for intraocular pressure control. Cox proportional hazards multivariate analysis was performed to identify independent risk factors. RESULTS: African American race (p=0.02), more than two preoperative glaucoma drugs (p=0.02), and intraocular pressure greater than 14 mmHg during the first postoperative week (p=0.006), were identified as significant independent risk factors requiring suture release for filtration failure during the first postoperative month. Their significance was further confirmed by Kaplan-Meier survival analysis with Mantel-Cox log-rank test (p=0.03, p=0.02, and p=0.001, respectively). CONCLUSIONS: African American race, more than two preoperative medications, and intraocular pressure greater than 14 mmHg in the first postoperative week are major independent risk factors for initial filtration failure requiring suture release during the first month after primary glaucoma triple procedure. The presence of the risk factors may warrant a more aggressive antiproliferative regimen and/or earlier suture release.
Dr. D.A. Morris, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, MI 48201-1423; USA
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
