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F. Shafi, P. Agrawal, F. Sii, P. Shah; Trabeculectomy With Mitomycin C: Early Postoperative Complication Outcomes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):601.
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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.
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).
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.
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.
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