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A. Lockwood, L. Anderson, S. Goverdahn, J. Kirwan; How Successful Is the Modern Trabeculectomy Using the Safe Surgery System in Primary Open Angle Glaucoma?. Invest. Ophthalmol. Vis. Sci. 2009;50(13):168.
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To determine the success of the Safe Surgical System of trabeculectomy in controlling intraocular pressure after 2 years in patients with primary open angle glaucoma
An open consecutive case series of patients with primary open angle glaucoma and no past history of glaucoma surgery. All underwent trabecuectomy with mitomycin C (MMC) or 5FU for uncontrolled intraocular pressure (IOP) despite maximally tolerated medical treatment. Surgical success was defined as complete if the IOP was 18 mm Hg or lower without the use of IOP lowering medications or qualified where the IOP was 18 mm Hg or less with the addition of hypotensive therapy.
Ninety eight eyes of 85 patients had a minimum follow up of 2 years. Ninety three (95 %) eyes had had no previous surgical procedure and 6 (5 %) had undergone uncomplicated phacoemulsification and intraocular lens insertion. At 2 years 91 (93 %) trabeculectomies achieved complete success and 95 (97 %) met the criteria for qualified success. Twenty two trabeculectomies (22 %) underwent needling with 5fu at mean day 23 post op (range day 1 - 485). Eight (8 %) received a second needling with 5fu at mean day 166 post op (range day 29 -506). Early surgical intervention included 4 resuturings and one reformation of an anterior chamber. Of the 3 patients that failed two were managed conservatively and had IOPs of 23 and one patient required a redo trabeculectomy at 13 months. Visual acuity at 2 years was within 2 lines of that before surgery in 95 (97 %) patients. One patient developed hypotony and a subsequent macular hole, one had uncontrolled disease due to poor attendance and one developed an epiretinal membrane. Ten patients developed cataract and had subsequent uncomplicated phaco + IOL. There were no late bleb leaks and no endophthalmitis.
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