May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Long term intraocular pressure control of patients who developed encapsulated blebs following trabeculectomy
Author Affiliations & Notes
  • V.P. Costa
    Ophthalmology, University of Campinas, Sao Paulo, Brazil
    Ophthalmology, University of São Paulo, São Paulo, Brazil
  • E. Arcieri
    Ophthalmology, University of Campinas, São Paulo, Brazil
  • T. Freitas
    Ophthalmology, University of Campinas, São Paulo, Brazil
  • Footnotes
    Commercial Relationships  V.P. Costa, None; E. Arcieri, None; T. Freitas, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 934. doi:
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      V.P. Costa, E. Arcieri, T. Freitas; Long term intraocular pressure control of patients who developed encapsulated blebs following trabeculectomy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):934.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To evaluate the long–term intraocular pressure (IOP) control of eyes that developed an encapsulated bleb following trabeculectomy. Methods: Between 1994 and 1995, 282 trabeculectomies were performed at the University of Campinas, Brazil. Among the 282 eyes, 25 developed encapsulated blebs and were randomized to medical treatment with aqueous humor suppressors or transconjunctival needling without adjunct antimetabolites. Among the 25 patients who developed an encapsulated bleb, 21 were followed for at least 6 months. A control group of 21 consecutive eyes which underwent trabeculectomy during the same period and by the same surgeons was selected. Success was defined as IOP < 21 mmHg with or without antiglaucoma medications. Failure was defined as IOP > 21 mmHg or when a new antiglaucoma surgery was indicated. Kaplan–Meier statistical survival analysis was performed to compare the groups. Results: Among the 21 eyes that developed encapsulated blebs, 12 (57%) had undergone transconjunctival needling and 9 (43%) had received medical treatment. There was no statistically significant difference regarding the mean age, and the distribution of gender and race among the groups. Mean follow–up was 30.0 ± 14.0 months for the needling group, 33.3 ± 18.5 months for the medical treatment group, and 37.4 ± 2.6 months for the control group (p=0.19). Mean IOP was significantly higher in the needling group (19.8 ± 4.1 mmHg) than in the medical treatment (14.0 ± 4.7 mmHg) and control groups (12.4 ± 3.4 mmHg) (p<0.0001) six months following trabeculectomy. There was no statistically significant difference in mean IOP values between the groups at all other time intervals. From the sixth postoperative month on, patients developing encapsulated blebs required significantly more antiglaucoma medications than the control group (p<0.05). Kaplan–Meier survival curves comparing the needling and the medical treatment groups demonstrated a tendency for a higher risk of failure in the needling group (p=0.054). The control group showed a significantly lower chance of failure than both groups developing encapsulated blebs (p<0.0001). Conclusion: Our findings indicate that encapsulated blebs are associated with an increased risk for surgical failure.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • wound healing 
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