Purchase this article with an account.
Takeshi Ono, Kenya Yuki, Shingo Hosoda, Naoki Ozeki, Daisuke Shiba, Kazuo Tsubota; Postoperative Flat Anterior Chamber, Incidence, Risk Factors, And Effect On The Long-term Success Of Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2517.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate the incidence, risk factors, and long-term effects of postoperative flat anterior chamber (FAC) development on the success rate of trabeculectomy with mitomycin C.
Data on 384 consecutive subjects (384 eyes) who underwent trabeculectomy or phacotrabeculectomy with mitomycin C at our institution between April 1, 1999 and March 31, 2009 were evaluated. Those who developed postoperative FAC were classified into 3 severity grades for analysis. Grade 1 was defined as contact between the iris and the cornea with touch limited to the periphery of the iris, Grade 2 as entire irido-corneal touch, and Grade 3 as total apposition between the iris and the cornea along with contact between the lens and the cornea. The control subjects were those in whom FAC was not diagnosed. The hazard ratios (HRs) for the failure of trabeculectomy caused by FAC after 5 years were examined in conjunction with multivariate Cox proportional hazards regression analysis. The risk factors for FAC were analyzed with a logistic regression model.
FAC was observed in 90 of the 384 eyes examined (90/384 = 21.1%). The occurrence of postoperative FAC was inversely associated with the long-term success rate of trabeculectomy (HR = 1.80 [95% CI: 1.05-3.09], p = 0.03). Cases of FAC were identified in this study as follows: Grade 1, 60 eyes (60/384 = 15.6%); Grade 2, 24 eyes (24/384 = 6.3%); and Grade 3, 6 eyes (6/384 = 1.6%). Subgroup analysis revealed that postoperative development of FAC at the Grade 2 and 3 severity levels significantly reduced the long-term success rate of trabeculectomy (HR = 2.27 [95% CI: 1.22-4.20], p = 0.009), whereas development of Grade 1 FAC did not (HR = 1.32 [95% CI: 0.67-2.60], p = 0.42). Preoperative phakia and low postoperative intraocular pressure were significant risk factors for the development of FAC of any grade.
The occurrence of postoperative FAC and its severity were associated with the failure of trabeculectomy.
Clinical Trial: :
This PDF is available to Subscribers Only