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Yuji Yamamoto, Kazuhiko Mori, Isao Yokota, Yoko Ikeda, Morio Ueno, Kojiro Imai, Haruna Yoshikawa, Satoshi Teramukai, Shigeru Kinoshita, Chie Sotozono; Does type of postoperative anti-glaucoma drug affect morphological changes of filtering bleb after trabeculectomy? – Utilizing the data from the Collaborative Bleb-Related Infection Incidence and Treatment Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2937.
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© ARVO (1962-2015); The Authors (2016-present)
Various factors affect the morphological changes of filtering blebs post trabeculectomy (TLE). The purpose of this present study was to investigate whether the type of postoperative anti-glaucoma medication (anti-GM) affects the changes of bleb morphology utilizing data from the Collaborative Bleb-Related Infection Incidence and Treatment Study (CBIITS), a multicenter prospective cohort study conducted by the Japan Glaucoma Society (Yamamoto et al., Ophthalmology 2014).
This study involved 51 glaucoma patients (32 males and 19 females, mean age: 64.8) out of 1098 cases from the CBIITS data sets. They were prescribed either prostaglandin analogues (PG Group) or β blockers (β-blocker Group) over a less-than 6-month time period. Patients with no bleb shape information, whose bleb had become smaller than the scleral flap size at 6-months post TLE, or who had undergone needling in less-than 6-months post TLE were excluded from the study. Bleb morphology was evaluated by the bleb characteristics of width (W) and depth (D). Bleb shape was described at 6-month intervals throughout the 5-year follow-up period, and each characteristic was compared between the two groups. Time to bleb failure was defined as the time from TLE until bleb failure, i.e., blebs became smaller than the scleral flap size (W and D) or had undergone needling. Cox proportional hazards regression model was used to examine the effects of the type of postoperative anti-GM after adjustment for sex, age, those combined with phacoemulsification and intraocular lens implantation or not, and those with a fornix-based flap or with a limbal-based flap.
Of the 1098 cases, 33 cases were PG Group and 18 cases were β-blocker Group. The failure-free advantage in favor of the PG Group was not significant in the characteristic of W (p=0.16, hazard-ratio (HR): 0.52; 95%CI: 0.21-1.32; median follow-up time: 42 months], and D [p=0.12, HR: 0.50; 95% CI: 0.20-1.20; median follow-up time: 36 months]. However, the failure-free period of the PG Group was longer than those of the β-blocker Group during the 5-year follow-up period.
The findings of this observational study show that the use of PG following TLE may maintain filtering blebs better than β-blocker.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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