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Ingrid Chang, Karine D Bojikian, Divakar Gupta, Philip P Chen; Early post-operative wound leak after trabeculectomy with mitomycin C with and without placement of bandage contact lens. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2952.
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© ARVO (1962-2015); The Authors (2016-present)
To assess whether placement of a bandage contact lens (BCL) after fornix-based trabeculectomy with mitomycin C (MMC) at the time of surgery affects early post-operative wound leak.
Retrospective chart review of all patients with glaucoma who underwent fornix based trabeculectomy with MMC as a sole procedure, at one institution (2 surgeons) from July 2007 to July 2014. An early wound leak was defined as one that developed within the first post-operative month.
90 eyes in 90 patients were studied, with a mean age (±SD) of 63.8± 16.0 years. There were 22 eyes (24%) identified with early post-operative wound leak. Mean time to wound leak development was 10.8 days, and average duration of wound leak was 3.4 weeks. Out of the 22 eyes with wound leak, 12 patients had placement of a BCL at the time of surgery and 10 patients did not have placement of BCL (p=0.80). Eleven out of 52 eyes (21%) that had placement of a BCL had post-operative wound leak compared to 10/38 eyes (26%) without BCL (p=0.36). For those with a wound leak, 16 (72.7%) eyes resolved with medical management alone (placement of BCL and topical antibiotic drops), and 6 (27.3%) eyes required trabeculectomy revision in the operating room. Rate of trabeculectomy revision for wound leak was not different between the group with placement of a BCL (4/14 eyes, 33%) versus those without a BCL (2/10 eyes, 20%, p=0.67). No significant differences were found in age, race, sex, type of glaucoma, prior laser peripheral iridotomy, prior laser trabeculoplasty, preoperative intraocular pressure, number of topical medications, preoperative visual acuity, and central corneal thickness between eyes with or without an early wound leak (p≥0.09).
Placement of a BCL after fornix-based trabeculectomy with MMC did not decrease the risk of an early postoperative wound leak, nor the rate of trabeculectomy revision for severe leak.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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