{"title":"Long-term Outcomes of Combined Phacotrabeculectomy Surgery in a Singapore Tertiary Hospital","authors":"","doi":"10.1016/j.apjo.2024.100102","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the long-term outcomes of phacotrabeculectomy from a tertiary glaucoma service in Singapore.</div></div><div><h3>Design</h3><div>Retrospective case series.</div></div><div><h3>Methods</h3><div>Seven hundred ninety-six eyes of 698 patients who underwent phacotrabeculectomy surgery at the Singapore National Eye Centre between 2005 and 2007 with a minimum follow-up of three years were included. The primary outcome measure was intraocular pressure (IOP). Secondary outcomes included best-corrected visual acuity (BCVA), number of glaucoma medications, and surgical complications.</div></div><div><h3>Results</h3><div>The mean age was 69.5 years, 51 % were male, and 86 % were Chinese. Most eyes had primary glaucoma (90.6 %). The mean follow-up duration was 9.4 years. The overall success rate at three years was 97 % if surgical success was defined as IOP ≤ 21 mm Hg, 92 % if IOP ≤ 18 mm Hg, 66 % if IOP ≤ 15 mm Hg. By Kaplan–Meier survival analysis over 13 years, the cumulative success rate fell from 98.1 % to 89.1 % if IOP ≤ 21 mm Hg, 98.1–76.9 % if IOP ≤ 18 mm Hg, 98–50.3 % if IOP ≤ 15 mm Hg. The postoperative IOP improved significantly at all time points (<em>P</em> < 0.05) and 72 % had at least 20 % IOP reduction. There was a slight improvement in postoperative BCVA (<em>P</em> < 0.05). The mean number of glaucoma medications was reduced postoperatively (<em>P</em> < 0.001). There were no significant risk factors for surgical failure.</div></div><div><h3>Conclusions</h3><div>Phacotrabeculectomy was found to be safe, resulting in clinically significant IOP lowering for 13 years with reduced dependency on glaucoma medications and improved BCVA.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia-Pacific Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2162098924001130","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose
To describe the long-term outcomes of phacotrabeculectomy from a tertiary glaucoma service in Singapore.
Design
Retrospective case series.
Methods
Seven hundred ninety-six eyes of 698 patients who underwent phacotrabeculectomy surgery at the Singapore National Eye Centre between 2005 and 2007 with a minimum follow-up of three years were included. The primary outcome measure was intraocular pressure (IOP). Secondary outcomes included best-corrected visual acuity (BCVA), number of glaucoma medications, and surgical complications.
Results
The mean age was 69.5 years, 51 % were male, and 86 % were Chinese. Most eyes had primary glaucoma (90.6 %). The mean follow-up duration was 9.4 years. The overall success rate at three years was 97 % if surgical success was defined as IOP ≤ 21 mm Hg, 92 % if IOP ≤ 18 mm Hg, 66 % if IOP ≤ 15 mm Hg. By Kaplan–Meier survival analysis over 13 years, the cumulative success rate fell from 98.1 % to 89.1 % if IOP ≤ 21 mm Hg, 98.1–76.9 % if IOP ≤ 18 mm Hg, 98–50.3 % if IOP ≤ 15 mm Hg. The postoperative IOP improved significantly at all time points (P < 0.05) and 72 % had at least 20 % IOP reduction. There was a slight improvement in postoperative BCVA (P < 0.05). The mean number of glaucoma medications was reduced postoperatively (P < 0.001). There were no significant risk factors for surgical failure.
Conclusions
Phacotrabeculectomy was found to be safe, resulting in clinically significant IOP lowering for 13 years with reduced dependency on glaucoma medications and improved BCVA.
期刊介绍:
The Asia-Pacific Journal of Ophthalmology, a bimonthly, peer-reviewed online scientific publication, is an official publication of the Asia-Pacific Academy of Ophthalmology (APAO), a supranational organization which is committed to research, training, learning, publication and knowledge and skill transfers in ophthalmology and visual sciences. The Asia-Pacific Journal of Ophthalmology welcomes review articles on currently hot topics, original, previously unpublished manuscripts describing clinical investigations, clinical observations and clinically relevant laboratory investigations, as well as .perspectives containing personal viewpoints on topics with broad interests. Editorials are published by invitation only. Case reports are generally not considered. The Asia-Pacific Journal of Ophthalmology covers 16 subspecialties and is freely circulated among individual members of the APAO’s member societies, which amounts to a potential readership of over 50,000.