Trabeculectomy with mitomycin C : Outcomes and risk factors for failure in phakic open-angle glaucoma
To evaluate long-term tonometric outcomes of trabeculectomy with adjunctive mitomycin C (MMC) and its efficacy in achieving a range of intraocular pressures (IOP) in phakic patients with open-angle glaucoma. Retrospective cohort study. Three levels of success were defined by these criteria: (A) IOP...
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| Veröffentlicht in: | Ophthalmology (Rochester, MN) MN), 2006-06, Vol.113 (6), p.930-936 |
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| creator | FONTANA, Hector NOURI-MAHDAVI, Kouros LUMBA, Joanna RALLI, Monica CAPRIOLI, Joseph |
| description | To evaluate long-term tonometric outcomes of trabeculectomy with adjunctive mitomycin C (MMC) and its efficacy in achieving a range of intraocular pressures (IOP) in phakic patients with open-angle glaucoma.
Retrospective cohort study.
Three levels of success were defined by these criteria: (A) IOP < or =18 mmHg and IOP reduction of 20%; (B) IOP < or =15 mmHg and IOP reduction of 25%; and (C) IOP < or =12 and IOP reduction of 30%. Kaplan-Meier survival analyses were used to assess outcomes. Cox's proportional hazard regression analysis was used to identify risk factors for failure.
Two hundred twenty-five phakic patients (292 eyes) with open-angle glaucoma, > or =40 years of age at time of trabeculectomy.
The primary outcome was qualified success rate (with or without medications) according to the defined criteria. Secondary outcomes include IOP level and number of medications at 1 and 3 years after surgery, postoperative complications, and need for further glaucoma surgery.
Mean IOP (+/-standard deviation) decreased from 18.8 mmHg (+/-6.1 mmHg) before surgery to 11.3 mmHg (+/-4.5 mmHg) at 1 year and 11.1 mmHg (+/-4.2 mmHg) at 3 years (P |
| doi_str_mv | 10.1016/j.ophtha.2006.01.062 |
| format | Article |
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Retrospective cohort study.
Three levels of success were defined by these criteria: (A) IOP < or =18 mmHg and IOP reduction of 20%; (B) IOP < or =15 mmHg and IOP reduction of 25%; and (C) IOP < or =12 and IOP reduction of 30%. Kaplan-Meier survival analyses were used to assess outcomes. Cox's proportional hazard regression analysis was used to identify risk factors for failure.
Two hundred twenty-five phakic patients (292 eyes) with open-angle glaucoma, > or =40 years of age at time of trabeculectomy.
The primary outcome was qualified success rate (with or without medications) according to the defined criteria. Secondary outcomes include IOP level and number of medications at 1 and 3 years after surgery, postoperative complications, and need for further glaucoma surgery.
Mean IOP (+/-standard deviation) decreased from 18.8 mmHg (+/-6.1 mmHg) before surgery to 11.3 mmHg (+/-4.5 mmHg) at 1 year and 11.1 mmHg (+/-4.2 mmHg) at 3 years (P<0.001 for both). The mean number of medications decreased from 2.8 (+/-1.0) to 0.4 (+/-0.7) at 1 year and 0.7 (+/-1.0) at 3 years (P<0.001 for both). The success rates were 85%, 84%, and 79% at 1 year for criteria A, B, and C, respectively; and 62%, 56%, and 46% for these criteria, respectively, at 3 years. Postoperative laser suture lysis was associated with a higher rate of failure for criteria B and C (P<0.001 for both), the hazard ratio (HR) was 1.7 for criteria B and 2.0 for criteria C. Prior argon laser trabeculoplasty was associated with higher risk of failure for criteria C (HR = 1.6; P = 0.05).
Trabeculectomy with MMC effectively reduces IOP in phakic open-angle glaucoma, but long-term low IOPs are achieved in only half of the cases. Laser suture lysis after trabeculectomy and prior argon laser trabeculoplasty are associated with a higher risk of failure when low IOPs are required.]]></description><identifier>ISSN: 0161-6420</identifier><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/j.ophtha.2006.01.062</identifier><identifier>PMID: 16647135</identifier><identifier>CODEN: OPHTDG</identifier><language>eng</language><publisher>New York, NY: Elsevier</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antimetabolites - therapeutic use ; Biological and medical sciences ; Cohort Studies ; Combined Modality Therapy ; Female ; Glaucoma and intraocular pressure ; Glaucoma, Open-Angle - drug therapy ; Glaucoma, Open-Angle - physiopathology ; Glaucoma, Open-Angle - surgery ; Humans ; Intraocular Pressure - physiology ; Intraoperative Complications ; Lens, Crystalline - physiology ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Mitomycin - therapeutic use ; Ophthalmology ; Retrospective Studies ; Risk Factors ; Trabeculectomy - methods ; Treatment Failure ; Treatment Outcome</subject><ispartof>Ophthalmology (Rochester, MN), 2006-06, Vol.113 (6), p.930-936</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,23930,23931,25140,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17838183$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16647135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FONTANA, Hector</creatorcontrib><creatorcontrib>NOURI-MAHDAVI, Kouros</creatorcontrib><creatorcontrib>LUMBA, Joanna</creatorcontrib><creatorcontrib>RALLI, Monica</creatorcontrib><creatorcontrib>CAPRIOLI, Joseph</creatorcontrib><title>Trabeculectomy with mitomycin C : Outcomes and risk factors for failure in phakic open-angle glaucoma</title><title>Ophthalmology (Rochester, MN)</title><addtitle>Ophthalmology</addtitle><description><![CDATA[To evaluate long-term tonometric outcomes of trabeculectomy with adjunctive mitomycin C (MMC) and its efficacy in achieving a range of intraocular pressures (IOP) in phakic patients with open-angle glaucoma.
Retrospective cohort study.
Three levels of success were defined by these criteria: (A) IOP < or =18 mmHg and IOP reduction of 20%; (B) IOP < or =15 mmHg and IOP reduction of 25%; and (C) IOP < or =12 and IOP reduction of 30%. Kaplan-Meier survival analyses were used to assess outcomes. Cox's proportional hazard regression analysis was used to identify risk factors for failure.
Two hundred twenty-five phakic patients (292 eyes) with open-angle glaucoma, > or =40 years of age at time of trabeculectomy.
The primary outcome was qualified success rate (with or without medications) according to the defined criteria. Secondary outcomes include IOP level and number of medications at 1 and 3 years after surgery, postoperative complications, and need for further glaucoma surgery.
Mean IOP (+/-standard deviation) decreased from 18.8 mmHg (+/-6.1 mmHg) before surgery to 11.3 mmHg (+/-4.5 mmHg) at 1 year and 11.1 mmHg (+/-4.2 mmHg) at 3 years (P<0.001 for both). The mean number of medications decreased from 2.8 (+/-1.0) to 0.4 (+/-0.7) at 1 year and 0.7 (+/-1.0) at 3 years (P<0.001 for both). The success rates were 85%, 84%, and 79% at 1 year for criteria A, B, and C, respectively; and 62%, 56%, and 46% for these criteria, respectively, at 3 years. Postoperative laser suture lysis was associated with a higher rate of failure for criteria B and C (P<0.001 for both), the hazard ratio (HR) was 1.7 for criteria B and 2.0 for criteria C. Prior argon laser trabeculoplasty was associated with higher risk of failure for criteria C (HR = 1.6; P = 0.05).
Trabeculectomy with MMC effectively reduces IOP in phakic open-angle glaucoma, but long-term low IOPs are achieved in only half of the cases. Laser suture lysis after trabeculectomy and prior argon laser trabeculoplasty are associated with a higher risk of failure when low IOPs are required.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antimetabolites - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Glaucoma and intraocular pressure</subject><subject>Glaucoma, Open-Angle - drug therapy</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>Lens, Crystalline - physiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mitomycin - therapeutic use</subject><subject>Ophthalmology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Trabeculectomy - methods</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><issn>0161-6420</issn><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFz0tLAzEUBeAgiq3VfyCSjcsZ85hkEndSfEGhm7ouSSbppJ0XyQzSf2-KFVf3LL5z4AJwj1GOEeZP-7wf6rFWOUGI5wjniJMLMMeskFlRYnoJ5onhjBcEzcBNjHuUIKfFNZhhzk-EzYHdBKWtmRprxr49wm8_1rD1p2x8B5fwGa6n0fStjVB1FQw-HqBTCYcIXR9S9s0ULEx4qNXBG9gPtstUt2ss3DVqSl11C66caqK9O98F-Hp73Sw_stX6_XP5ssoGQuWYaVoUjGDJiOC6opogS2xVCmZpKR3j2pWKCuIklcKhyrCqQBpryZyxTBhJF-Dhd3eYdGur7RB8q8Jx-_dvAo9noKJRjQuqMz7-u1JQgQWlP37FZzc</recordid><startdate>20060601</startdate><enddate>20060601</enddate><creator>FONTANA, Hector</creator><creator>NOURI-MAHDAVI, Kouros</creator><creator>LUMBA, Joanna</creator><creator>RALLI, Monica</creator><creator>CAPRIOLI, Joseph</creator><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>20060601</creationdate><title>Trabeculectomy with mitomycin C : Outcomes and risk factors for failure in phakic open-angle glaucoma</title><author>FONTANA, Hector ; NOURI-MAHDAVI, Kouros ; LUMBA, Joanna ; RALLI, Monica ; CAPRIOLI, Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p239t-b34452195286bd3b20e2ed785e379f56bf7a382f9398f0dc5d40b1b95fce58c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antimetabolites - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Glaucoma and intraocular pressure</topic><topic>Glaucoma, Open-Angle - drug therapy</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>Lens, Crystalline - physiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mitomycin - therapeutic use</topic><topic>Ophthalmology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Trabeculectomy - methods</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FONTANA, Hector</creatorcontrib><creatorcontrib>NOURI-MAHDAVI, Kouros</creatorcontrib><creatorcontrib>LUMBA, Joanna</creatorcontrib><creatorcontrib>RALLI, Monica</creatorcontrib><creatorcontrib>CAPRIOLI, Joseph</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Ophthalmology (Rochester, MN)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FONTANA, Hector</au><au>NOURI-MAHDAVI, Kouros</au><au>LUMBA, Joanna</au><au>RALLI, Monica</au><au>CAPRIOLI, Joseph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trabeculectomy with mitomycin C : Outcomes and risk factors for failure in phakic open-angle glaucoma</atitle><jtitle>Ophthalmology (Rochester, MN)</jtitle><addtitle>Ophthalmology</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>113</volume><issue>6</issue><spage>930</spage><epage>936</epage><pages>930-936</pages><issn>0161-6420</issn><eissn>1549-4713</eissn><coden>OPHTDG</coden><abstract><![CDATA[To evaluate long-term tonometric outcomes of trabeculectomy with adjunctive mitomycin C (MMC) and its efficacy in achieving a range of intraocular pressures (IOP) in phakic patients with open-angle glaucoma.
Retrospective cohort study.
Three levels of success were defined by these criteria: (A) IOP < or =18 mmHg and IOP reduction of 20%; (B) IOP < or =15 mmHg and IOP reduction of 25%; and (C) IOP < or =12 and IOP reduction of 30%. Kaplan-Meier survival analyses were used to assess outcomes. Cox's proportional hazard regression analysis was used to identify risk factors for failure.
Two hundred twenty-five phakic patients (292 eyes) with open-angle glaucoma, > or =40 years of age at time of trabeculectomy.
The primary outcome was qualified success rate (with or without medications) according to the defined criteria. Secondary outcomes include IOP level and number of medications at 1 and 3 years after surgery, postoperative complications, and need for further glaucoma surgery.
Mean IOP (+/-standard deviation) decreased from 18.8 mmHg (+/-6.1 mmHg) before surgery to 11.3 mmHg (+/-4.5 mmHg) at 1 year and 11.1 mmHg (+/-4.2 mmHg) at 3 years (P<0.001 for both). The mean number of medications decreased from 2.8 (+/-1.0) to 0.4 (+/-0.7) at 1 year and 0.7 (+/-1.0) at 3 years (P<0.001 for both). The success rates were 85%, 84%, and 79% at 1 year for criteria A, B, and C, respectively; and 62%, 56%, and 46% for these criteria, respectively, at 3 years. Postoperative laser suture lysis was associated with a higher rate of failure for criteria B and C (P<0.001 for both), the hazard ratio (HR) was 1.7 for criteria B and 2.0 for criteria C. Prior argon laser trabeculoplasty was associated with higher risk of failure for criteria C (HR = 1.6; P = 0.05).
Trabeculectomy with MMC effectively reduces IOP in phakic open-angle glaucoma, but long-term low IOPs are achieved in only half of the cases. Laser suture lysis after trabeculectomy and prior argon laser trabeculoplasty are associated with a higher risk of failure when low IOPs are required.]]></abstract><cop>New York, NY</cop><pub>Elsevier</pub><pmid>16647135</pmid><doi>10.1016/j.ophtha.2006.01.062</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0161-6420 |
| ispartof | Ophthalmology (Rochester, MN), 2006-06, Vol.113 (6), p.930-936 |
| issn | 0161-6420 1549-4713 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Aged Aged, 80 and over Antimetabolites - therapeutic use Biological and medical sciences Cohort Studies Combined Modality Therapy Female Glaucoma and intraocular pressure Glaucoma, Open-Angle - drug therapy Glaucoma, Open-Angle - physiopathology Glaucoma, Open-Angle - surgery Humans Intraocular Pressure - physiology Intraoperative Complications Lens, Crystalline - physiology Male Medical sciences Middle Aged Miscellaneous Mitomycin - therapeutic use Ophthalmology Retrospective Studies Risk Factors Trabeculectomy - methods Treatment Failure Treatment Outcome |
| title | Trabeculectomy with mitomycin C : Outcomes and risk factors for failure in phakic open-angle glaucoma |
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