Purpose:
The "ReGAE "(Research into Glaucoma And Ethnicity) Project assesses the surgical outcome of augmented trabeculectomy with mitomycin C in the management of progressive glaucomatous optic neuropathy. This study reports the prevalence of potentially blinding complications in the early post-operative period (within 3 months) from this series of 500 consecutive surgical cases.
Methods:
Prospective, consecutive, non-comparative case series of 500 eyes undergoing trabeculectomy with mitomycin C. Complications occurring within 3 months of surgery were recorded. Clinically significant early hypotony (CSEH) was defined as an IOP < 6 mmHg during the first post-operative month associated with either a shallow anterior chamber, choroidal detachment or hypotony maculopathy assessed to require intervention (viscoelastic support to anterior chamber, scleral flap suture or conjunctival suture).
Results:
Data was collected from 500 consecutive surgical cases. Figure 1 shows the complication rates in this series. Higher complication rates were noted in Asian and African-Caribbean patients compared to Caucasians patients. Asian patients experiencing a complication were more likely to require further surgical intervention. Serious visual loss occurred in 0.2% of eyes. Most complications were self-limiting; however, 4.4% of patients needed intervention for CSEH.
Conclusions:
Low rates of potentially blinding complications in the early postoperative period can be achieved, even in complex surgical cases. Complications were encountered more frequently in African-Caribbean and Asian patients. Asian patients experiencing a complication were more likely to require further surgical intervention. A combination of pre-operative, intra-operative and post-operative techniques can be used to ensure safe surgery.
Keywords: intraocular pressure