Ab interno trabeculectomy revision with 5-flourouracil for failed trabeculectomy in advanced glaucoma: 3-year outcomes

To describe the 3-year outcomes of patients who underwent ab interno trabeculectomy revision with a translimbal sclerostomy spatula augmented with 5-flourouracil. Retrospective cohort study. In this single-centre study, inclusion criteria included patients who were 18 years of age or older with advanced glaucoma who had undergone ab interno trabeculectomy revision with 5-flourouracil due to subconjunctival fibrosis and above-target intraocular pressure (IOP). Patients were required to have a minimum follow-up of 3 years. The primary outcome measure was IOP. Secondary outcome measures included number of topical IOP-lowering medications, best-corrected distance visual acuity, visual field mean deviation, and postoperative complications. Forty-one eyes of 41 patients met the criteria for inclusion. Survival analysis demonstrated success defined by criterion A (IOP 20% reduction) in 44% of eyes without medication (complete success) and 71% of eyes with or without medication (qualified success) at 3-year follow-up. Complete and qualified successes defined by criterion B (IOP 20% reduction) were achieved by 31% and 44% of eyes, respectively. Early complications included transient hypotony in 26 eyes (63%) and transient hyphema in 3 eyes (7.3%). No persistent complications were reported within the 3-year study period. Ab interno trabeculectomy revision can be an effective technique for achieving a low target IOP in patients with advanced glaucoma in up to 3-year follow-up. Décrire les résultats à 3 ans chez les patients qui ont subi une révision de trabéculectomie ab interno réalisée au moyen d'une spatule à sclérostomie translimbique adjuvantée de 5-fluorouracil. Étude de cohorte rétrospective. Les critères d'inclusion de cette étude tenue dans un seul centre comprenaient l’âge (au moins 18 ans), la présence d'un glaucome avancé qui a fait l'objet d'une révision de trabéculectomie ab interno adjuvantée de 5-fluorouracile en raison d'une fibrose sous-conjonctivale et, enfin, une pression intraoculaire (PIO) supérieure aux valeurs cibles. Les patients devaient avoir été suivis pendant au moins 3 ans. Le principal paramètre de mesure était la PIO. Au nombre des paramètres secondaires, mentionnons le nombre de collyres antiglaucomateux, la meilleure acuité visuelle corrigée de loin, la déviation moyenne du champ visuel et les complications postopératoires. Ainsi, 41 yeux de 41 patients répondaient aux critères d'inclusion. Selon l'analy