Effectiveness of trabeculectomy on glaucoma patients in Ibadan

Abstract

This study was designed to determine the effectiveness of trabeculectomy on African patients. All patients who underwent trabeculectomy over a 10-year period, January 1987 to December 1996 were included in the study. Information extracted from their case notes included age, sex, type of glaucoma, number of years of glaucoma before surgery, eye involved, and visual acuity pre-operatively and postoperatively. Intraocular pressures at presentation, preoperatively and post operatively (2 days, 1 week, 3 months, 6 months, 12 months and last clinic visit) were also recorded. Other data collected included pre-operative anti glaucoma therapy, additional techniques at surgery, complications of surgery, presence of a filtering bleb and follow-up period post operatively. A success rate of 91.2% was obtained from 433 eyes operated upon, The most significant outcome was the presence of a filtering bleb which had a better success rate than the absence of a bleb. High success rates were recorded in the age groups “>60 years and 20-40 years", the lowest success rate was in the “less than 20 years of age". All the patients with developmental glaucoma had a successful outcome (100%) while only 50% of the secondary glaucoma were successful. Patients with open angle glaucoma had 92% success rate. Complications of surgery were mostly transient. It was concluded that the presence of a bleb was a good indication of the control of intraocular pressure and that early surgery gave a more successful outcome than late surgery.