January 31, 2014
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Trabeculectomy after vitreoretinal surgery with silicone oil yields low success rate

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A majority of patients who underwent trabeculectomy with mitomycin C for glaucoma after vitreoretinal surgery with silicone oil failed to attain IOP less than 21 mm Hg, according to a study.

Investigators measured IOP, visual acuity and glaucomatous neuropathy status before surgery and multiple times up to 1 year postoperatively in 19 consecutive patients with uncontrolled IOP after silicone oil removal despite taking the maximum number of tolerable medications. Twelve cases were deemed failures at 1 year.

Mean baseline preoperative IOP of 42.5 mm Hg decreased to 23.82 mm Hg at 1 year postoperatively (P = .008).

Nine of 19 patients with IOP less than 21 mm Hg without medication after the first month postoperatively were considered absolute successes, but at the end of 12 months, only three were considered absolute successes, maintaining reduced IOP without medication or needling. Four of the nine required medication or needling and were reclassified as qualified successes. The 12 failures required a second trabeculectomy, glaucoma drainage or cycloablation.

The study authors noted that the 12-month absolute success rate was lower than that of trabeculectomy in other refractory glaucomas.

Disclosure: The authors have no relevant financial disclosures.