Trabeculectomy in young Nigerian patients

Abstract

The results of89 trabeculectomies performed on 56 patients under

the age of30 years were reviewed. Data collected included age,

sex, type or glaucoma, number of years of glaucoma before

surgery, visual acuity, intraocular pressure, complications of

surgery, presence of a filtering bleb and follow-up period.

Complete success, denoted by a postoperative lOP of 21mmHg

or less without medical therapy, occurred in 50 eyes (56.2%).

Qualified success, in which lOP was 21mmHg or less with

additional medical therapy occurred in 31 eyes (34.9%) and

failure, in which lOP was greater than 21mmHg in spite of

medical treatment occurred in 8 eyes (8.9%). Success was

therefore achieved in 91.1 % attaining an lOP of 21mmHg or

less, with or without additional medical therapy. The most

statistically significant factor was age groups in which the highest

success rate of I00% was achieved in the age group 20-29 years.

The difference in the success rate across the age groups was

statistically significant (x? = 8.04, p = 0.0 I). Fornix based

conjunctival flaps were also found to be associated with a

statistically significant higher success rate (97.9%) as opposed

to limbal based flaps (85.4%), X2= 4.81, p = 0.03. Males in the

study group had a significantly higher success rate (97%) than

females (78.3%), X2= 5.86, P = 0.011. A success rate of 100%

was recorded in patients with developmental glaucoma, 86.1%

in congenital glaucoma and 33.3% in secondary glaucoma. All

the repeat trabeculectomies had congenital glaucoma. The

presence of a bleb, although it had a higher success rate (93.4%)

compared with the absence ofa bleb (84.6%), was not statistically

significant (x2 = 1.19, P = 0.27). Complications of surgery were

mostly transient.