Surgical Outcomes of Trabeculectomy in Patients with Glaucoma Over 80 Years of Age

Abstract

Purpose: To compare the surgical outcomes of trabeculectomy performed in elderly patients (>80 years) with those of younger controls.

Methods: We retrospectively reviewed the charts of patients who underwent trabeculectomy from 1/1/2009 through 4/31/2011 at the Wills Eye Hospital. Patients over 80 years of age were compared with younger controls. Outcome measures included intraocular pressure (IOP), visual acuity, number of glaucoma medications, surgical complications and surgical failure. Surgical failure was defined as IOP >21 mmHg, <20% reduction below baseline IOP, IOP<5 mmHg, reoperation for glaucoma, or loss of light perception. In addition, the number of missed post-operative visits was documented.

Results: Eighty-six eyes of patients over 80 years of age (81-94) were compared with 86 eyes of younger controls (22-79). Mean follow-up time was 23.9±8.0 and 25.1±8.0 months for each group, respectively. Failure rate was 31.3% in the elderly group, compared with 29.5% in the control group (P=0.98). Post-operative complications were similar between the groups (P=0.25). Elderly patients were less likely to return for their follow-up appointments (P=0.04).

Conclusions: The surgical outcomes of trabeculectomy in patients older than 80 years of age were similar to those of younger controls. Taking into consideration their general health condition and life expectancy, elderly patients with glaucoma may benefit from surgery in order to preserve their visual function. Appointment reminders and patient navigators may help improve follow-up adherence.

Keywords: 568 intraocular pressure • 413 aging