June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Risk factors for persistent hypotony after trabeculectomy in Collaborative Bleb-related Infection Incidence and Treatment Study
Author Affiliations & Notes
  • Tomomi Higashide
    Ophthalmology, Kanazawa Univ Sch of Med Sci, Kanazawa, Japan
  • Shinji Ohkubo
    Ophthalmology, Kanazawa Univ Sch of Med Sci, Kanazawa, Japan
  • Yosuke Sugimoto
    Ophthalmology, Hiroshima University, Hiroshima, Japan
  • Yoshiaki Kiuchi
    Ophthalmology, Hiroshima University, Hiroshima, Japan
  • Kazuhisa Sugiyama
    Ophthalmology, Kanazawa Univ Sch of Med Sci, Kanazawa, Japan
  • Footnotes
    Commercial Relationships Tomomi Higashide, None; Shinji Ohkubo, None; Yosuke Sugimoto, None; Yoshiaki Kiuchi, None; Kazuhisa Sugiyama, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 931. doi:
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      Tomomi Higashide, Shinji Ohkubo, Yosuke Sugimoto, Yoshiaki Kiuchi, Kazuhisa Sugiyama; Risk factors for persistent hypotony after trabeculectomy in Collaborative Bleb-related Infection Incidence and Treatment Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):931.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To investigate the incidence and risk factors for persistent hyopotony after trabeculectomy in the Collaborative Bleb-related Infection Incidence and Treatment Study, a prospective multicenter study conducted by the Japan Glaucoma Society to investigate the incidence and treatment outcome of bleb-related infection.

Methods: Nine hundred and sixty eyes of 960 patients who underwent trabeculectomy with mitomycin C and enrolled in the Collaborative Bleb-related Infection Incidence and Treatment Study were studied. The cases with unknown glaucoma types or lack of baseline or follow-up intraocular pressure (IOP) data which made the judgment of IOP control impossible were excluded. Surgical failure was defined as insufficient IOP reduction (IOP >21 mmHg at 2 consecutive follow-up visits scheduled every 6 months until 5 years, <20% IOP reduction from baseline, or reoperation to reduce IOP). In the surgical success cases, the cumulative incidence and the risk factors for persistent hypotony (≤5 mmHg persisted for more than 6 months) were analyzed by Kaplan-Meier survival analysis and Cox regression analysis.

Results: The surgical success was achieved in 689 cases (71.8%) with mean follow-up periods of 51.7 months (median, 60 months; range, 12 - 60 months). The incidence of persistent hypotony was 2.9 ± 0.6%, 6.2 ± 1.0%, and 9.2 ± 1.2%(± standard error) at 1, 3, and 5 years postoperatively. Multivariate Cox regression analysis showed that limbus-based conjunctival flap, baseline IOP (mmHg), and bleb infection were significant risk factors for persistent hypotony (hazard ratio, p value: 1.99, 0.027;0.96, 0.016;4.13, 0.018; respectively).

Conclusions: The incidence of persistent hypotony increased over time after successful trabeculectomy with mitomycin C. A limbus-based conjunctival flap, low baseline IOP, and bleb infection were identified as the risk for persistent hypotony.

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