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Surgical treatment of glaucomas by trabeculectomy--indications and early results.

AIM
To evaluate the indications for surgical treatment of glaucomas, the stage of the disease in which it was performed, and the intraoperative and early postoperative complications.


PATIENTS AND METHODS
We studied retrospectively 106 eyes of 106 consecutive patients who received trabeculectomy for refractory glaucoma between 2001 and 2007.


RESULTS
Sixty-three (59.4%) of the patients had had the disease for at least two years before it was detected. The majority of the patients were in advanced stage of the disease with their intraocular pressures exceeding 25 mm Hg. The most common intraoperative complications were hyphaema--9 patients (8.5%), flat anterior chamber--7 patients (6.6%), vitreous loss--1 (0.9%), phacodonesis--1 (0.9%). The early postoperative complications included hyphaema--8 patients (7.5%), flat anterior chamber--24 (22.6%), choroidal effusion--16 (15.1%), leakage--2 (1.9%), striate keratitis--3 (2.8 %), posterior synechia--2 (1.9%), hypotony--15 (14.2%), high IOP--4 (3.8%). These results are consistent with those reported elsewhere for similar groups of patients.


CONCLUSIONS
The postoperative complication rate can be lowered significantly if the indications for surgery, the type and stage of glaucoma are accurately assessed and the technique of trabeculectomy is well mastered. Trabeculectomy is a reliable alternative to unsuccessful medical or laser treatment.