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V. M. Gerente, C. V. S. Regatieri, S. H. Teixeira, A. Paranhos Jr.; Trabeculectomy Learning Curve: Limbus versus Fornix Based Conjunctival Flaps - Efficacy and Complications. Invest. Ophthalmol. Vis. Sci. 2007;48(13):844.
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To evaluate the success rate and complications of fornix orlimbus based (FB and LB) trabeculectomy performed by surgeonsin training.
Prospective randomized trial, performed at Federal Universityof São Paulo. Glaucomatous patients with trabeculectomyindication were randomized for FB or LB surgery, which was performedby a surgeon in training and assisted by an experienced one.The outcomes were: intraocular pressure (IOP) and complications.Success criteria were IOP ≤18 mmHg or greater than 30% IOP reductionwithout medication (criteria 1), and IOP ≤18 mmHg or greaterthan 30% IOP reduction with maximum 2 medications (criteria2).
We studied 49 surgeries: 27 FB and 22 LB. The mean follow upwas 10 months (FB) and 9 months (LB). Complications were classifiedin early (within the first week) and late (after 7 days).Table1- Early complicationsTable2 - Late complications*CD:choroidal detatchment**AC: anterior chamber72% of FB group metcriteria 1 and 80 % met criteria 2. In LB group, 85.7% met criteria1 and 95.3% met criteria 2. There was no statistically significantdifference between groups for success rate (p 0.7266 for criteria1; p 0.2040 for criteria 2).
Success rate of LB and FB trabeculectomy performed by surgeonsin training were similar. There was an increased occurrenceof cataract in FB group (p .004). FB patients also had an increasednumber of Siedel within the first week compared to LB group,and almost reached statistical significance.
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