Purpose: To compare long-term surgical outcomes in exfoliative glaucoma (XFG) versus primary open-angle glaucoma (POAG) after primary trabeculectomy with mitomycin-C.
Methods: This retrospective, case-control study included 32 eyes of XFG and 64 eyes of POAG matched by propensity score analysis. Surgical success was defined according to 3 different criteria: (1) intraocular pressure (IOP)<18 mm Hg and IOP reduction ≥20% without medication; (2) IOP<15 mm Hg and IOP reduction ≥25% without medication; and (3) IOP<18 mm Hg and IOP reduction ≥20% with or without medication. Cumulative probabilities of success were compared using Kaplan-Meier survival analysis, and risk factors of surgical failure were analyzed.
Results: Cumulative success rates were 84.4% at 1 year and 19.9% at 5 years for XFG, and 82.3% and 64.7%, respectively, for POAG by criterion A. Complete success rates were significantly lower for XFG than for POAG by criteria A and B. However, qualified success, as determined by criterion C, did not show a statistically significant difference. Postoperative hyphema was more frequent for XFG. The risk factors associated with surgical failure were a young age (<60 y; hazard ratio=2.58, P=0.047, criterion A) and exfoliation syndrome (hazard ratio=3.01, 2.96, P=0.006, 0.005, criteria A and B).
Conclusions: Although trabeculectomy for XFG had success rates similar to POAG at 1 year, XFG showed poorer long-term IOP control from 2 years postoperatively. This study indicates that it is more difficult to achieve long-term low target IOP control in eyes with XFG than in eyes with POAG after trabeculectomy with mitomycin-C.
*Department of Ophthalmology, Daegu Veterans Health Service Medical Center
†Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Republic of Korea
Presented as poster at the Annual Meeting of the Association for Research in Vision and Ophthalmology, 2014, Orlando, FL.
Disclosure: The authors declare no conflict of interest.
Reprints: Soon Cheol Cha, MD, PhD, #170 Hyunchungro, Nam-gu, Daegu 705-717, Republic of Korea (e-mail: firstname.lastname@example.org).
Received March 18, 2015
Accepted November 18, 2015