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Trabeculectomy with or without intraoperative sub-tenon injection of triamcinolone acetonide in treating secondary glaucoma.

Author(s): Yuki K, Shiba D, Kimura I, Ohtake Y, Tsubota K

Affiliation(s): Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. glaucoma.keio@gmail.com

Publication date & source: 2009-06, Am J Ophthalmol., 147(6):1055-60, 1060.e1-2. Epub 2009 Mar 27.

Publication type: Comparative Study; Randomized Controlled Trial

PURPOSE: To investigate the efficacy of intraoperative sub-Tenon injection of triamcinolone acetonide (TA) in increasing the success rate of trabeculectomy for the treatment of secondary glaucoma. DESIGN: Prospective randomized controlled clinical trial. METHODS: Fifty-three consecutive eyes scheduled for trabeculectomy were randomly allocated in an institutional setting. In the study group (n = 26), TA was injected in the sub-Tenon at the conclusion of the surgery. In the control group (n = 27) surgery was completed without TA injection. Surgical success was defined as a complete success if the intraocular pressure (IOP) was 21 mm Hg or less with an IOP reduction of greater than or equal to 20% without any antiglaucoma medication. Success rates in both groups were compared using Kaplan-Meier survival curves and the log-rank test. The morphologic characteristics of the filtering blebs were evaluated using the Indiana Bleb Appearance Grading Scale. RESULTS: Fifty-three eyes completed the study (26 in the study group and 27 in the control group), with a follow-up of 12 months. Complete success rates were 65.4% for the study group and 63.0% for the control group (P = .77) at 12 months. The morphologic characteristics of the filtering blebs and postoperative complications were similar in the study and the control eyes (P > .40). IOP measurements in both groups were similar at all visits (P > .05). CONCLUSIONS: Trabeculectomy with intraoperative sub-Tenon injection of TA for the treatment of secondary glaucoma neither increased the intermediate-term success rate nor decreased postoperative complications.

Page last updated: 2009-10-20

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