Otago glaucoma surgery outcome study: Long-term results of trabeculectomy—1976 to 1995
To provide data on the long-term results of trabeculectomy performed in the province of Otago, New Zealand. Retrospective noncomparative case series. A total of 289 eyes of 193 patients (excluding 4 eyes lost to follow-up soon after operation); all trabeculectomies performed for the first time on ca...
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| Veröffentlicht in: | Ophthalmology (Rochester, Minn.) Minn.), 1999-09, Vol.106 (9), p.1742-1750 |
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| container_title | Ophthalmology (Rochester, Minn.) |
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| creator | Molteno, Anthony C.B. Bosma, Nicola J. Kittelson, John M. |
| description | To provide data on the long-term results of trabeculectomy performed in the province of Otago, New Zealand.
Retrospective noncomparative case series.
A total of 289 eyes of 193 patients (excluding 4 eyes lost to follow-up soon after operation); all trabeculectomies performed for the first time on cases of primary glaucoma from 1976 through 1995.
Standard Cairns trabeculectomy.
Intraocular pressure, visual acuity, visual field damage.
Trabeculectomy was effective in controlling intraocular pressure at a level of 21 mmHg or less, with probabilities of 0.93 (95% confidence interval [CI], 0.90–0.97), 0.87 (95% CI, 0.82–0.93), and 0.85 (95% CI, 0.77–0.92) at 5, 10, and 15 years, respectively, after surgery. The mean visual acuity improved from 20/60 to 20/40 immediately after trabeculectomy but then declined steadily over the postoperative years. The decline in visual acuity led to blindness in 47 eyes. The Kaplan-Meier estimated probability of retaining useful vision (visual acuity > 20/400 and visual field > 5° radius) in the overall group was 0.87 (95% CI, 0.79–0.91), 0.72 (95% CI, 0.60–0.79), and 0.6 (95% CI, 0.43–0.69) at 5, 10, and 15 years, respectively, after surgery. Those eyes that had good preoperative visual acuity (visual acuity ≥ 20/30) had a significantly better chance of retaining useful vision (
P = 0.02).
The intraocular pressure was well controlled by trabeculectomy, but a steady long-term decline in visual acuity and visual field occurred, decreasing the probability of an eye retaining useful vision up to the time of death to approximately 0.6. |
| doi_str_mv | 10.1016/S0161-6420(99)90351-2 |
| format | Article |
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Retrospective noncomparative case series.
A total of 289 eyes of 193 patients (excluding 4 eyes lost to follow-up soon after operation); all trabeculectomies performed for the first time on cases of primary glaucoma from 1976 through 1995.
Standard Cairns trabeculectomy.
Intraocular pressure, visual acuity, visual field damage.
Trabeculectomy was effective in controlling intraocular pressure at a level of 21 mmHg or less, with probabilities of 0.93 (95% confidence interval [CI], 0.90–0.97), 0.87 (95% CI, 0.82–0.93), and 0.85 (95% CI, 0.77–0.92) at 5, 10, and 15 years, respectively, after surgery. The mean visual acuity improved from 20/60 to 20/40 immediately after trabeculectomy but then declined steadily over the postoperative years. The decline in visual acuity led to blindness in 47 eyes. The Kaplan-Meier estimated probability of retaining useful vision (visual acuity > 20/400 and visual field > 5° radius) in the overall group was 0.87 (95% CI, 0.79–0.91), 0.72 (95% CI, 0.60–0.79), and 0.6 (95% CI, 0.43–0.69) at 5, 10, and 15 years, respectively, after surgery. Those eyes that had good preoperative visual acuity (visual acuity ≥ 20/30) had a significantly better chance of retaining useful vision (
P = 0.02).
The intraocular pressure was well controlled by trabeculectomy, but a steady long-term decline in visual acuity and visual field occurred, decreasing the probability of an eye retaining useful vision up to the time of death to approximately 0.6.</description><identifier>ISSN: 0161-6420</identifier><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/S0161-6420(99)90351-2</identifier><identifier>PMID: 10485545</identifier><identifier>CODEN: OPHTDG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Female ; Follow-Up Studies ; Glaucoma, Angle-Closure - physiopathology ; Glaucoma, Angle-Closure - surgery ; Glaucoma, Open-Angle - physiopathology ; Glaucoma, Open-Angle - surgery ; Humans ; Intraocular Pressure - physiology ; Intraoperative Complications ; Male ; Medical sciences ; Middle Aged ; New Zealand ; Postoperative Complications ; Probability ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the eye and orbit ; Trabeculectomy ; Treatment Outcome ; Visual Acuity - physiology ; Visual Fields - physiology</subject><ispartof>Ophthalmology (Rochester, Minn.), 1999-09, Vol.106 (9), p.1742-1750</ispartof><rights>1999 American Academy of Ophthalmology, Inc.</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0161-6420(99)90351-2$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1988254$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10485545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Molteno, Anthony C.B.</creatorcontrib><creatorcontrib>Bosma, Nicola J.</creatorcontrib><creatorcontrib>Kittelson, John M.</creatorcontrib><title>Otago glaucoma surgery outcome study: Long-term results of trabeculectomy—1976 to 1995</title><title>Ophthalmology (Rochester, Minn.)</title><addtitle>Ophthalmology</addtitle><description>To provide data on the long-term results of trabeculectomy performed in the province of Otago, New Zealand.
Retrospective noncomparative case series.
A total of 289 eyes of 193 patients (excluding 4 eyes lost to follow-up soon after operation); all trabeculectomies performed for the first time on cases of primary glaucoma from 1976 through 1995.
Standard Cairns trabeculectomy.
Intraocular pressure, visual acuity, visual field damage.
Trabeculectomy was effective in controlling intraocular pressure at a level of 21 mmHg or less, with probabilities of 0.93 (95% confidence interval [CI], 0.90–0.97), 0.87 (95% CI, 0.82–0.93), and 0.85 (95% CI, 0.77–0.92) at 5, 10, and 15 years, respectively, after surgery. The mean visual acuity improved from 20/60 to 20/40 immediately after trabeculectomy but then declined steadily over the postoperative years. The decline in visual acuity led to blindness in 47 eyes. The Kaplan-Meier estimated probability of retaining useful vision (visual acuity > 20/400 and visual field > 5° radius) in the overall group was 0.87 (95% CI, 0.79–0.91), 0.72 (95% CI, 0.60–0.79), and 0.6 (95% CI, 0.43–0.69) at 5, 10, and 15 years, respectively, after surgery. Those eyes that had good preoperative visual acuity (visual acuity ≥ 20/30) had a significantly better chance of retaining useful vision (
P = 0.02).
The intraocular pressure was well controlled by trabeculectomy, but a steady long-term decline in visual acuity and visual field occurred, decreasing the probability of an eye retaining useful vision up to the time of death to approximately 0.6.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glaucoma, Angle-Closure - physiopathology</subject><subject>Glaucoma, Angle-Closure - surgery</subject><subject>Glaucoma, Open-Angle - physiopathology</subject><subject>Glaucoma, Open-Angle - surgery</subject><subject>Humans</subject><subject>Intraocular Pressure - physiology</subject><subject>Intraoperative Complications</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>New Zealand</subject><subject>Postoperative Complications</subject><subject>Probability</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the eye and orbit</subject><subject>Trabeculectomy</subject><subject>Treatment Outcome</subject><subject>Visual Acuity - physiology</subject><subject>Visual Fields - physiology</subject><issn>0161-6420</issn><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc9KJDEQxoO4OOPoIyg5iOihNX866Y4XWQZ1FwY8qOAtpNPVQ0v3RPNHmNs-xD7hPolRx_VSRVE_vqK-D6EDSs4oofL8LhdayJKRE6VOFeGCFmwLTakoVVFWlG-j6X9kgnZDeCKESMnLHTShpKyFKMUUPd5Gs3R4OZhk3WhwSH4Jfo1dinkGHGJq1xd44VbLIoIfsYeQhhiw63D0pgGbBrDRjet_f_5SVUkcHaZKiT30ozNDgP1Nn6GH66v7-a9icXvze_5zUQBTLBa1orY2tJWVskS1jHJuZcUMsMaahnVEENnVVhBgAlqRVyCBVg3trGBCcj5Dx5-6z969JAhRj32wMAxmBS4FXRHCab6SwcMNmJoRWv3s-9H4tf7yIgNHG8AEa4bOm5Xtwzen6pqJMmOXnxjkr1578DrYHlYW2t5nJ3Tr-qyp30PSHyHp9wS0UvojJM34G-jGglo</recordid><startdate>19990901</startdate><enddate>19990901</enddate><creator>Molteno, Anthony C.B.</creator><creator>Bosma, Nicola J.</creator><creator>Kittelson, John M.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19990901</creationdate><title>Otago glaucoma surgery outcome study: Long-term results of trabeculectomy—1976 to 1995</title><author>Molteno, Anthony C.B. ; Bosma, Nicola J. ; Kittelson, John M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e292t-891c8a1d679c09d2133c672ae2bcab2f0506f8c50e25ed5672e6e17b1fc525633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glaucoma, Angle-Closure - physiopathology</topic><topic>Glaucoma, Angle-Closure - surgery</topic><topic>Glaucoma, Open-Angle - physiopathology</topic><topic>Glaucoma, Open-Angle - surgery</topic><topic>Humans</topic><topic>Intraocular Pressure - physiology</topic><topic>Intraoperative Complications</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>New Zealand</topic><topic>Postoperative Complications</topic><topic>Probability</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the eye and orbit</topic><topic>Trabeculectomy</topic><topic>Treatment Outcome</topic><topic>Visual Acuity - physiology</topic><topic>Visual Fields - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Molteno, Anthony C.B.</creatorcontrib><creatorcontrib>Bosma, Nicola J.</creatorcontrib><creatorcontrib>Kittelson, John M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology (Rochester, Minn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Molteno, Anthony C.B.</au><au>Bosma, Nicola J.</au><au>Kittelson, John M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Otago glaucoma surgery outcome study: Long-term results of trabeculectomy—1976 to 1995</atitle><jtitle>Ophthalmology (Rochester, Minn.)</jtitle><addtitle>Ophthalmology</addtitle><date>1999-09-01</date><risdate>1999</risdate><volume>106</volume><issue>9</issue><spage>1742</spage><epage>1750</epage><pages>1742-1750</pages><issn>0161-6420</issn><eissn>1549-4713</eissn><coden>OPHTDG</coden><abstract>To provide data on the long-term results of trabeculectomy performed in the province of Otago, New Zealand.
Retrospective noncomparative case series.
A total of 289 eyes of 193 patients (excluding 4 eyes lost to follow-up soon after operation); all trabeculectomies performed for the first time on cases of primary glaucoma from 1976 through 1995.
Standard Cairns trabeculectomy.
Intraocular pressure, visual acuity, visual field damage.
Trabeculectomy was effective in controlling intraocular pressure at a level of 21 mmHg or less, with probabilities of 0.93 (95% confidence interval [CI], 0.90–0.97), 0.87 (95% CI, 0.82–0.93), and 0.85 (95% CI, 0.77–0.92) at 5, 10, and 15 years, respectively, after surgery. The mean visual acuity improved from 20/60 to 20/40 immediately after trabeculectomy but then declined steadily over the postoperative years. The decline in visual acuity led to blindness in 47 eyes. The Kaplan-Meier estimated probability of retaining useful vision (visual acuity > 20/400 and visual field > 5° radius) in the overall group was 0.87 (95% CI, 0.79–0.91), 0.72 (95% CI, 0.60–0.79), and 0.6 (95% CI, 0.43–0.69) at 5, 10, and 15 years, respectively, after surgery. Those eyes that had good preoperative visual acuity (visual acuity ≥ 20/30) had a significantly better chance of retaining useful vision (
P = 0.02).
The intraocular pressure was well controlled by trabeculectomy, but a steady long-term decline in visual acuity and visual field occurred, decreasing the probability of an eye retaining useful vision up to the time of death to approximately 0.6.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10485545</pmid><doi>10.1016/S0161-6420(99)90351-2</doi><tpages>9</tpages></addata></record> |
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| ispartof | Ophthalmology (Rochester, Minn.), 1999-09, Vol.106 (9), p.1742-1750 |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Female Follow-Up Studies Glaucoma, Angle-Closure - physiopathology Glaucoma, Angle-Closure - surgery Glaucoma, Open-Angle - physiopathology Glaucoma, Open-Angle - surgery Humans Intraocular Pressure - physiology Intraoperative Complications Male Medical sciences Middle Aged New Zealand Postoperative Complications Probability Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the eye and orbit Trabeculectomy Treatment Outcome Visual Acuity - physiology Visual Fields - physiology |
| title | Otago glaucoma surgery outcome study: Long-term results of trabeculectomy—1976 to 1995 |
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