4-YEAR FOLLOW UP OF PATIENTS AFTER GONIOTREPANATION

• Main Authors: Mojca Hudovernik, Dušica Pahor
• Format: Article
• Language: English
• Published: Slovenian Medical Association 2002-12-01
• Series: Zdravniški Vestnik
• Subjects: glaucoma; filtering surgery; visual field; optic nerve head
• Online Access: http://vestnik.szd.si/index.php/ZdravVest/article/view/1720

<p>Background. To present the success of goniotrepanation in patients with glaucoma 4 years after surgery.</p><p>Methods. We performed follow-up of 32 patients (50 eyes), who had undergone Fronimopoulus goniotrepanation without use of antimetabolites in our department because of poorly controlled primary open-angle or angle-closure glaucoma and pseudoexfoliative glaucoma between January 1995 and May 1996. The success of operation was assessed 4 years after operation by evaluating the stability of the visual field, stability of the optic nerve head changes and values of the intraocular pressure (IOP) lower than 21 mm Hg.</p><p>Results. Mean preoperative IOP was 27 mm Hg, one year postoperatively 15 mm Hg and 4 years after the surgery 14 mm Hg (mean drop of IOP was 48%). 1 year after surgery IOP was lower than 21 mm Hg without treatment in 37 eyes (74%) and with additional topical treatment in 12 eyes (24%). After 4 years additional topical treatment was necessary in 54% eyes. Only in 2 patients (4%) revision soon after surgery was performed (because of Tenon’s cyst in one case and hypotony in the other). In 1 eye (2%) intraoperative subhoroidal expulsive hemorrhage occurred. In 19 eyes (39%) cataract developed 4 years after surgery. The success of surgery after 4 years was 94%; in 22 eyes (44%) without treatment, in 25 eyes (50%) with additional topical treatment and in 2 eyes (4%) additional surgery was needed.</p><p>Conclusions. Goniotrepanation without use of antimetabolites can be effective treatment for patients with pseudoexfoliative glaucoma and open-angle glaucoma.<br /><br /></p>