Risa Caraher-Masuda, Mari Sakamoto, Mina Okuda, Fumio Takano, Sotaro Mori, Kaori Ueda, Akiyasu Kanamori, Yuko Yamada-Nakanishi, Makoto Nakamura
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引用次数: 0
Abstract
Purpose: To report the 3-year outcomes of surgical bleb revision (SBR) with mitomycin C (MMC) for early scarring bleb after trabeculectomy (TLE).
Study design: Retrospective observational study.
Methods: We included glaucoma patients aged ≧ 18 who underwent SBR with MMC within 6 months of their first TLE at Kobe University Hospital and were followed for at least 6 months. The primary outcome measure was the three-year success rate of SBR. We defined surgical success as: intraocular pressure (IOP) reduction ≧ 20% from baseline and 5 ≦ IOP ≦ 18 mmHg. Failure was defined when the IOP deviated from the criteria, when the eye required additional glaucoma surgery, and when the eye lost light perception. Complete success (CS) was success without glaucoma medications and qualified success (QS) was success with glaucoma medications. The secondary outcome measures included IOP, the number of glaucoma medications, mean deviation (MD), best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), and surgical complications.
Results: Sixty-eight eyes of 68 patients were analyzed. The median interval between initial TLE and SBR was 2 months. Overall success rate at three-year after SBR were 45.1% and 9.6% for QS and CS, respectively. A greater number of medications used before TLE was a contributing factor to failure (P = 0.02). 22 eyes (32.4%) underwent additional glaucoma surgery, and 41 eyes (60.3%) were spared from additional glaucoma surgery within 3 years after SBR. The median IOP decreased form 24.0 mmHg to 11.0 mmHg 3 years after SBR, and the number of medications decreased from 4 to 2 (P < 0.01). MD remained unchanged, but BCVA and ECD decreased at 3years postoperatively. There were no serious complications of SBR.
Conclusion: SBR may be an effective treatment option for early scarring blebs after TLE but is unsuccessful in eyes that have used many glaucoma medications prior to TLE.
期刊介绍：
The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication.
Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.
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