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Abstract #6236 Published in IGR 2-2
Long term results of glaucoma surgery among participants in an east African population survey
Quigley HA; Buhrmann RR; West SK; Isseme I; Scudder M; Oliva MSBritish Journal of Ophthalmology 2000; 84: 860-864
AIM: To evaluate the long-term results of glaucoma surgery among people in East Africa. METHODS: Participants in a population-based survey of eye disease prevalence were offered glaucoma surgery using standardised criteria. Either surgical iridectomy or trabeculectomy was carried out as indicated by a medical officer or by one of two ophthalmologists. Trabeculectomy methods included releasable sutures and mitomycin C in the majority of eyes. Subjects were examined during the first week and two months after surgery. Nearly three years later, re-examination was carried out in those who were still resident in the region. RESULTS: Among 46 people who were offered iridectomy, trabeculectomy, or combined cataract extraction/lens implant/trabeculectomy, 21 people underwent surgery (46%). Of the 21, 19 were re-examined at three years (90%), including 16/18 eyes after trabeculectomy. Among these, intraocular pressure (IOP) declined from 29.9 (SD 9.4) to 14.7 (5.9) mmHg, with 16 of 18 eyes (89%) achieving a reduction >25%. Hypotony maculopathy, late bleb leak, and late endophthalmitis were not detected. Visually significant cataract developed in five of 15 re-examined eyes that underwent trabeculectomy alone (33%), possibly associated with preexisting cataract and diagnosis of angle closure glaucoma, but not with mitomycin C use. CONCLUSIONS: Nearly half those with glaucoma among residents of rural African villages accepted the offer of surgical therapy. While technical success was achieved at satisfactory levels, the development of cataract must be considered an important issue for application of glaucoma surgical therapy programs.
Dr. H.A. Quigley, Wilmer 120, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
