Name

258 - Existe-il une pression intra-oculaire cible, après une trabéculectomie, qui peut prédire le contrôle à long terme?

The aim of this study was to determine an early postoperative IOP level (cut-off IOP) that predicts an appropriate long-term control in patients following initial trabeculectomy with MMC.

In this retrospective epidemiological study, we reviewed 66 eyes of patients, presenting various types of glaucoma, who underwent a trabeculectomy with MMC at the Eye & Ear University Hospital, Beirut, Lebanon, between January 2015 and January 2016. Findings such as best-corrected visual acuity (BCVA), intra-ocular pressure (IOP), number of anti-glaucoma medications, surgical outcome and complications were noted throughout the follow-up. Prognostic factors associated with good long-term control were also reviewed. Failure was defined as exceeding a target IOP of 15 mmHg at 1-year follow-up or on three consecutive visits. A multivariate logistic regression analysis by a stepwise selection method with a 0.1 level of significance was set in order to set a cut-off IOP associated with success.

The mean follow-up duration was 16.4 ± 5.6 months [range, 12-24 months] in 40 men and 26 women (60.6% and 39.4%, respectively). The multivariate analysis showed a lower probability of success with diabetes. A mean IOP of ≤ 9 mmHg was of a clinical use in terms of providing success at 1-year follow-up, defined as target IOP ≤ 15 mmHg. However, a boundary of IOP ≤ 7 mmHg was associated with surgically related complications.

A minimum of 7 mmHg is acceptable in terms of preventing surgically related complications. A mean of 9 mmHg or less is in a relation with a better long-term control at 1-year follow-up. Knowing whether or not to perform laser suture lysis and the best timing to do so is crucial to determine this IOP.

A boundary IOP of ≤ 9 mmHg is recommended in order to ensure a suitable control at 1-year. A minimum of 7 mmHg is acceptable for low surgically related complications.