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Olusola Oluyinka Olawoye, Adeyinka Ashaye; Long term outcomes of augmented trabeculectomy with 5-Fluorouracil in Nigeria. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2725.
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© ARVO (1962-2015); The Authors (2016-present)
To report the long term outcomes and complication rates following trabeculectomy with 5- fluorouracil in a case series of Nigerians.
This was a prospective, observational, non-comparative case series. All patients with glaucoma who had trabeculectomy with 5 Fluorouracil at the University College Hospital Nigeria between June 2009 and May 2010 were included. Each patient had a complete ophthalmic evaluation.<br /> The post-operative intraocular pressure (IOP), visual acuity outcomes and post operative complications were assessed. Survival analysis was performed with a minimum follow up 12months. Complete success was defined as intraocular pressure of ≤21mmHg, <18mmHg, 15mmHg without anti-glaucoma medications while qualified success was defined as intraocular pressure of ≤21mmHg, <18mmHg, 15mmHg with anti-glaucoma medications.
Of the 292 patients who presented with glaucoma (mean age 56.5±16.6, 55.5% males) during this period, a total of 44 eyes of 30 patients (10.3%), aged 10-80 years had trabeculectomy with 5-FU. Their mean age was 48.9±19.6 (median age of 52 years) with a male preponderance (67.7%). The mean presenting intraocular pressure was 31.8±12.2mmHg. The mean deviation on Humphrey visual field was 15.9±9.7 (median of 13dB) with majority of the patients (57.4%) presenting with advanced glaucoma (MD >12dB). At 3 years post operatively 56.8% achieved complete success while 91.9% achieved qualified success at an IOP cut off of ≤21mmHg. At the same time point of 3 years and an IOP cut off of <15mmHg, 48.6% achieved complete success while 59.5% achieved qualified success. At a mean post operative period of 40.8±12.2 months, (range 18-60 months), mean IOP had reduced from a preoperative mean of 31.8±12.2mmHg to 14.6±4.3mmHg (P<0.001). Survival rates at 12 months, 24 months and 36 months were 93.2%, 89.5%, and 88.8% respectively.<br /> Early postoperative hypotony requiring surgical intervention occurred in 3 patients (6.8%). Other complications such as blebitis, hypotonic maculopathy and malignant glaucoma did not occur in this case series.
Trabeculectomy is effective in the long term in reducing IOP with minimal complications in Nigerians
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