Trabeculectomy with β radiation: Long-term follow-up

Abstract

Purpose: To evaluate the long-term outcome and complications of trabeculectomy with β radiation. Design: Retrospective noncomparative case series. Participants: Forty-three patients with confirmed primary open-angle glaucoma (POAG), who received trabeculectomy with adjunctive β radiation at the Prince of Wales Hospital between June 1991 and November 1994. Methods: Patients fulfilling the preceding criteria were followed up longitudinally. The visual acuity, intraocular pressure (IOP), bleb morphology, and complications were evaluated. Main Outcome Measures: Visual acuity, IOP, bleb morphology, complications. Results: Forty-three eyes of 43 consecutive Chinese patients were recruited and successfully followed up for a minimum of 7 years. The mean age ± 1 standard deviation (SD) was 60.9 ± 13.0 years. There were 29 males and 14 females. The mean baseline IOP ± 1 SD was 28.3 ± 5.8 mmHg. The mean postoperative IOP ± 1 SD after the initial trabeculectomy was 11.9 ± 4.3 mmHg, and the mean number of preoperative IOP-lowering eyedrops ± 1 SD was reduced from 2.8 ± 0.5 to 0.7 ± 1.0 at 7 years follow-up. The qualified success rate at 7 years follow-up, defined as IOP ≤ 21 mmHg with and without medication(s), was 88.4%. The complete success rate at 7 years defined as IOP ≤ 21 mmHg without medication was 60.7%. Two eyes developed blebitis, and one of them progressed to corneal decompensation after the infection. One eye had hypotony, and one eye had a traumatic ruptured bleb. Twelve eyes (27.9%) developed significant cataract. No corneal ulceration or scleral necrosis was encountered. Conclusions: From this noncomparative study, trabeculectomy with a single dose of 1000 rad β radiation used as an adjunctive measure for POAG in Chinese eyes had achieved a qualified success rate of 88.4% at 7 years. © 2003 by the American Academy of Ophthalmology.