Outcomes and risk factors for failure after trabeculectomy in Taiwanese patients: medical chart reviews from 2006 to 2017

Aims To determine long-term outcomes and risk factors for failure after mitomycin C (MMC)-augmented initial trabeculectomy (IT) in Taiwanese patients. Methods We reviewed medical records of patients with glaucoma undergoing IT during December 2006-December 2016. We defined complete success as an intraocular pressure (IOP) of >5 or <= 21 mm Hg or IOP reduction of >= 20% from baseline without supplemental medications and qualified success as the aforementioned IOP levels with or without supplemental medications. Kaplan-Meier survival and Cox proportional analyses evaluated success rates and risk factors for failure, respectively. Results We enrolled 190 patients (237 eyes; mean age: 54.0 +/- 15.3 years; mean postoperative follow-up period: 68.4 +/- 35.1 months). Mean IOP and glaucoma medications decreased from 22.2 +/- 10.8 to 14.4 +/- 5.2 mm Hg (p<0.001) and 3.0 +/- 0.7 to 1.8 +/- 1.2 (p=0.015), respectively, at the last visit. Cumulative qualified success rates were 93.9%, 93.0%, 86.5% and 67.1% at the 1, 2, 5 and 10 years follow-up, respectively; however, only 7.7% of the eyes reached complete success at the last visit. Eyes with poor preoperative visual acuity were associated with low qualified success rates (HR=1.689, p=0.027); patients aged >70 years had higher complete success rates than did those aged <= 70 years. Five cases (2.11%) exhibited bleb-associated complications. Conclusion Despite satisfactory long-term success rates, most eyes needed medication for IOP control, supporting the notion of predisposed scarring vitality in patients of Chinese ethnicity following MMC-augmented trabeculectomy.

Automated summary

The study aimed to determine long-term outcomes and risk factors for failure after MMC-augmented IT in Taiwanese patients. The results showed that despite satisfactory long-term success rates, most eyes still required medication for IOP control, and eyes with poor preoperative visual acuity had lower qualified success rates, while patients aged >70 years had higher complete success rates.