Conjunctival flap advancement with or without scleral graft for hypotony maculopathy after trabeculectomy

• 作者: Abdelhamid Shaker Elhofi Amir AbouSamra Mohamed Fahmy Doheim
• 来源期刊: 国际眼科杂志:英文版
• 学科: 医学
• 关键词: TRABECULECTOMY scleral melting revision surgery hypotony maculopathy
• 年，卷（期）: 2020,（7）
• 页码范围: 1079-1086
• 页数: 8页
• 分类号: R779.6

摘要

AIM: To investigate the outcomes of adaptive conjunctival flap advancement surgical techniques with or without scleral graft for patients undergoing revision surgery after trabeculectomy.METHODS: This retrospective study included 28 eyes of 28 subjects from December 2015 to April 2018. A group of 15 eyes underwent conjunctival advancement only while the other 13 eyes did conjunctival advancement with partial thickness scleral graft. In both study groups, we considered the intraocular pressure(IOP) as our primary outcome and visual acuity(VA) as our secondary outcome. Both were assessed pre-and post-operatively till the last followup possible point. Additionally, we classified the patients according to complete and qualified success criteria.RESULTS: The mean age of the conjunctival advancement group was 36.87±19.25 y, while it was 44.08±18.04 in the other group. In both study groups, the mean IOP significantly increased after revision surgery at 1, 2, 3 mo and the last follow-up visit when compared to prior the surgery(P<0.001). Moreover, VA was significantly improved(P=0.03) in the final follow-up for both surgical techniques. When we compared the change from baseline in both groups, there was no significant difference between IOP improvement in 1 mo(P=0.263), while the difference was significant in 2 mo(P=0.03), 3 mo(P=0.02) and in the final follow-up visit postoperatively. However, this difference was not significant regarding VA(P=0.5).CONCLUSION: The both adaptive techniques of conjunctival advancement and conjunctival advancement with scleral graft are effective for treating patients with lateonset hypotony. Yet, more prospective studies are needed to assert upon these results.