Augmented trabeculectomy-outcomes of first hundred versus second hundred surgeries of a fellowship-trained glaucoma surgeon

Abstract

Purpose: We aim to compare the outcomes of trabeculectomy with mitomycin-C by a fellowship-trained glaucoma surgeon in the first hundred compared to second hundred surgeries. Patients and methods: Retrospective review of 200 consecutive surgeries from May 2015 to January 2017. Primary outcomes were intraocular pressure (IOP) control and use of IOP-lowering medications. Success between first hundred (Group 1) and second hundred (Group 2) patients were reported using World Glaucoma Association guidelines. Kaplan-Meier survival demonstrated complete success and qualified success. Secondary outcome measures were postoperative complications, bleb interventions and additional procedures. Results: We found no statistical difference between the first hundred and second hundred patient’s postoperative IOP at week 4 ( p = 0.17), 3 months ( p = 0.74), 6 months ( p = 0.46), 12 months ( p = 0.47), 18 months ( p = 0.13) or at final follow up ( p = 0.53). The mean final follow up period was 3.6 ± 0.7 years. Mean IOP reduction in Group 1 was from 27.1 ± 10.8 to 12.6 ± 7.1 ( p < 0.0001) and Group 2 from 22.8 ± 8.4 to 11.3 ± 4.2 ( p < 0.0001). Kaplan-Meier graphs showed no significant difference in complete success ( p = 0.0693) or qualified success ( p = 0.0866) between Group 1 and Group 2. Bleb interventions were not statistically significant between two groups. There was a significantly higher rate of complications with the first hundred patients ( p < 0.0001). Conclusion: Both first hundred and second hundred patient groups achieved statistically similar outcomes in long term IOP control. Significant reduction of complications was achieved in the second group of patients.