Status of Intraocular pressure and complication profile of patients undergoing micro-Trabeculectomy at a tertiary care teaching hospital. A cohort study

Prof. Afroz Khan; Dr. Imtiyaz Ahmad; Dr. Asif Amin Vakil

Volume : IX, Issue : VIII, August - 2020

Status of Intraocular pressure and complication profile of patients undergoing micro-Trabeculectomy at a tertiary care teaching hospital. A cohort study

Prof. Afroz Khan, Dr. Imtiyaz Ahmad, Dr. Asif Amin Vakil

Abstract :

Background: IOP control at the early postoperative period is critical for successful Trabeculectomy. It is no exaggeration to say that long–term surgical results are determined by early IOP control. Objectives of the study was to report on the medium to long term IOP control following micro–Trabeculectomy employing a 2x2mm superficial scleral flap and 0.75 mm internal ostium in a cohort of eyes at relatively low risk for surgical failure. Methodology: The cohort study was conducted on patients attending Postgraduate Department of Ophthalmology Government Medical College, Srinagar. A total of 41 cases with the diagnosis of primary open angle glaucoma were included in the study and the cohort was followed postoperatively at 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months interval. At each visit a full ocular examination was performed. Results: Majority of the cases were males, 30 (73.1%) and among males most of the cases 13 (43.5%) were in the age group of 60–70 years. On the pre–operative assessment of the studies cases, majority of the cases 23 (56.2%) were having a cup disc ratio between 0.7–0.8 mm, majority 23(56.2%0 had IOP between 31–40 mmHg preoperatively followed by 14 (34.2%) cases who had IOP between 21`–30 mmHg. The mean IOP at week 1` was 12.15 ± 4.20 mmHg and at 6 months it was 16.59 ± 1.91` mmHg. Moreover, the mean change in IOP measured pre–operatively and at 6 months was found to be 16.63 ± 5.84 mmHg. The association was found to be statistically significant (p<0.001). Majority 20 (48.3%) studied cases had thin polycystic (I) blebs followed by flat diffuse blebs among 16 (39.5%) cases. The most common complications like raised IOP was found in 3 (7.5%) cases while hyphaema and the shallow anterior chamber was found in 2 (5%) cases only. Conclusion: micro–Trabeculectomy is safe and effective at reducing IOP in low–risk glaucoma eyes with IOP control and complication profile similar to previous reports of filtering surgery utilizing larger scleral flaps.