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SJ Glover, M Smith, MC Graham; Microcysts after Trabeculectomy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3376.
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Purpose: To assess whether conjunctival microcysts are an early indicator of long term success in glaucoma filtering operations. [The 2 previous studies on this subject one retrospective and one prospective came to opposite conclusions]. To see whether their dissappearance is correlated with impending failure of the filter as has been suggested.If so this may allow earlier intervention with needling and anti metabolite injection. Also to describe the natural history of these changes we examine patients at 1 day post operatively and between and after the 1 week and 1 month visits. Methods: Consecutive prospective recruitment of 59 patients who had glaucoma filtering surgery in a one year period. We looked at one week and then one month postoperatively for the presence or absence of easily seen microcysts over or around the filtering site. The one observer was blind to the clinical progress of the patients. We then assessed the outcome at 12 months post operatively. Success was defined as a pressure less than 21 on no treatment in open angle glaucoma, or less than 16/a drop of 4 from pre-operative levels on no treatment in normal tension glaucoma. Partial success was defined as above with 1-2 eyedrops being used. Failure was defined as using more than 2 drops, using acetazolamide, having repeated filtering surgery or uncontrolled intra ocular pressure. Results: Those with microcysts at both points had a success rate of 87.5 % [ 7/8] at 12 months 100% if partial successes included [1/8]. Those with microcysts at 1 week but not 1 month did not show a high rate of total failure 18% [ 2/11], partial success was 45% [ 5/11], total success 36%[4/11]. Conclusion: Microcysts may be an indicator of long term success of glaucoma filtering operations. We could not correlate their dissappearance with impending failure of the filter.
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