Change in visual acuity and associated risk factors after trabeculectomy with adjunctive mitomycin C.

Abstract

PURPOSE:

To report the 5-year incidence of visual impairment after mitomycin C-augmented trabeculectomy (MMC trabeculectomy) and the risk factors for visual impairment.

METHODS:

This is a multicentre prospective observational cohort study. Among glaucoma patients registered in the Collaborative Bleb-related Infection Incidence and Treatment Study performed in Japan, the patients with eyes meeting the following qualifications were included: eyes with primary open-angle glaucoma; eyes with primary angle-closure glaucoma; eyes with exfoliative glaucoma; eyes with ≥3/60 in blindness analysis; and eyes with ≥20/60 in low-vision analysis and visual acuity loss analysis. The patients were followed at 6-month intervals for 5 years. The entry data and follow-up data were analysed to determine the incidence of blindness (<3/60), low vision (≥3/60 and <20/60) and visual acuity loss (≥0.2 logMAR) during the follow-up period. Risk factors for visual impairment were also analysed.

RESULTS:

A total of 694 eyes of 694 or 559 eyes of 559 glaucoma patients were subjected to the blindness analysis or the low-vision and visual acuity loss analysis, respectively. Visual acuity significantly deteriorated (p < 0.0001): 12.2% (95%CI: 9.8-14.7%) of the patients became blind; 12.1% (95%CI: 9.4-14.9%) were judged to have low vision at the final examination; 28.3% (95%CI: 24.5-32.0%) were judged to have visual acuity loss. Glaucoma subtypes, poor preoperative visual function and postoperative complications are the main risk factors for visual impairment.

CONCLUSIONS:

Visual acuity was significantly reduced after MMC trabeculectomy in 5 years, and we identified several risk factors associated with this complication.

• Authors: Kenji Kashiwagi, Satoshi Kogure, Fumihiko Mabuchi, Tatsuya Chiba, Tetsuya Yamamoto, Yasuaki Kuwayama, Makoto Araie, Collaborative Bleb-Related Infection Incidence and Treatment Study Group
• Journal: Acta ophthalmologica (Acta Ophthalmol) Vol. 94 Issue 7 Pg. e561-e570 (Nov 2016) ISSN: 1755-3768 [Electronic] England
• PMID: 27156361 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study)
• Copyright: © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Chemical References

• Alkylating Agents
• Mitomycin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Alkylating Agents (administration & dosage)
• Combined Modality Therapy
• Exfoliation Syndrome (surgery)
• Female
• Glaucoma (surgery)
• Glaucoma, Angle-Closure (surgery)
• Glaucoma, Open-Angle (surgery)
• Humans
• Incidence
• Intraocular Pressure (physiology)
• Male
• Middle Aged
• Mitomycin (administration & dosage)
• Postoperative Complications
• Prospective Studies
• Risk Factors
• Tonometry, Ocular
• Trabeculectomy
• Vision Disorders (epidemiology, physiopathology)
• Visual Acuity (physiology)