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P. Agrawal, F. Shafi, F. Sii, P. Shah; Medium-Term Outcomes of Augmented Trabeculectomy With Mitomycin C in African-Caribbean Patients and Factors Influencing Survival. Invest. Ophthalmol. Vis. Sci. 2010;51(13):595.
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To evaluate the medium term outcomes of augmented trabeculectomywith mitomycin C in a large case series of African-Carribeansand to identify factors influencing survival.
Single surgeon prospective study of 47 eyes of 47 consecutiveAFC patients. Association between survival and study factorswas examined using Fisher’s exact test. Logistic regressionwas used to establish the combination of factors best predictingsurvival. Success was defined as an intraocular pressure (IOP)reduction to ≤ 21 mmHg, ≤ 18 mmHg and ≤ 15 mmHg without glaucomamedication (criterion 1) or IOP reduction to ≤ 21 mmHg, ≤ 18 mmHgand ≤ 15 mmHg with or without glaucoma medication (criterion2).
The mean follow-up period was 48.6 months. At final follow-upthe mean IOP reduced from 33.7 mmHg to 13.1 mmHg (p<0.001)and the mean number of topical medications fell from 2.83 to0.73 (p<0.001). Survival rates were 96%, 90% and 86% at 12,24 and 36 months, respectively, with a mean survival time of97.4 months (95% confidence interval, 86.0-108.8) for an IOP≤ 21 mmHg using criterion 2. Trabeculectomy survival individuallycorrelated significantly with the absence of preoperative acetazolamide,phakic eyes and preoperative highest and immediate IOP at 36months (p < 0.05). Hypotony requiring surgical interventionoccurred in 4 (8.5%) patients. There were no cases of blebitisor endophthalmitis.
Augmented trabeculectomy with mitomycin C was associated witha 61% reduction in IOP. The preoperative absence of acetazolamide,phakic eyes and lower preoperative IOPs were major factors influencingtrabeculectomy survival in this high-risk population.
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