Clinical Study
Eye (2006) 20, 304–308. doi:10.1038/sj.eye.6701865; published online 1 April 2005
Long-term intraocular pressure control of eyes that developed encapsulated blebs following trabeculectomy
The authors have no proprietary interest on any substance or instrument mentioned in this study.
This study was presented at the 2004 ARVO Meeting in Fort Lauderdale, USA.
V P Costa1,2, E S Arcieri1,3 and T G Freitas1
- 1Department of Ophthalmology, University of Campinas, Brazil
- 2Department of Ophthalmology, University of São Paulo, Brazil
- 3Department of Ophthalmology, Federal University of Uberlândia, Brazil
Correspondence: VP Costa, Department of Ophthalmology, University of Campinas, Rua Bauru, 40, Pacaembu, São Paulo, SP 01248-010, Brazil. Tel/Fax: +55 11 3865 9630; E-mail: vp.costa@uol.com.br
Received 24 August 2004; Accepted 15 February 2005; Published online 1 April 2005.
Abstract
Purpose
To evaluate the long-term intraocular pressure (IOP) control of eyes that developed an encapsulated bleb (EB) following trabeculectomy.
Methods
Between 1994 and 1995, 25 eyes developed EBs and were randomized to medical treatment or needling without adjunct antimetabolites. Among the 25 patients who developed an EB, 21 were followed for at least 6 months. A control group of 21 consecutive eyes, which underwent trabeculectomy during the same period and that did not develop EBs was retrospectively selected. Success was defined as IOP <21 mmHg with or without medications. Kaplan–Meier survival analysis was performed to compare the groups.
Results
Among the 21 eyes that developed EBs, 12 (57%) had undergone transconjunctival needling and nine (43%) had received medical treatment. Mean follow-ups were 30.0
14.0 months, 33.318.5 months, and 37.42.6 months for the needling, medical treatment, and control groups, respectively (P=0.19). Kaplan–Meier survival curves demonstrated that the control group showed a significantly lower chance of failure than both the needling and the medical treatment groups (P<0.0001).
Conclusion
Encapsulated blebs may be associated with an increased risk for surgical failure.
Keywords:
glaucoma, trabeculectomy, failure encapsulated bleb
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