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Incisional Therapies: Complications of Glaucoma Surgery

  • Marlene R. Moster
  • Augusto Azuara-Blanco
Chapter

Abstract

A guarded filtration procedure, frequently called trabeculectomy, has been the gold standard for initial surgery for glaucoma almost since its inception in the late 1960s (Fig. 70.1). The current form of this procedure has been attributed to Cairns. Overall, severe visual loss is uncommon, but the incidence of transient complications is high. For example, in the Collaborative Initial Glaucoma Treatment Study (CIGTS), early complications occurred in 50% of 465 trabeculectomies. The most frequent complications were shallow or flat anterior chamber (13%), encapsulated bleb (12%), ptosis (12%), serous choroidal detachment (11%), and hyphema (10%). Suprachoroidal hemorrhage occurred in 0.7% of cases, and there were no cases of endophthalmitis. In the United Kingdom, a national survey of trabeculectomy was conducted, and of 1,240 reported cases, early complications were reported in 46% and late complications in 42% of cases. The most common early complications were hyphema (24%), shallow anterior chamber (23%), hypotony (24%), wound leak (17%), and choroidal detachment (14%). The most frequent late complications were cataract (20%), visual loss (18%), and encapsulated bleb (3%). Recently, the tube versus trabeculectomy (TVT) study in 212 patients found intraoperative complications in 10 and 7% of cases during trabeculectomy and tube surgery, respectively, and postoperative complications in 57 and 34% of patients after trabeculectomy and tube surgery, respectively. Most complications were self-limited.

Keywords

Anterior Chamber Fibrin Glue Glaucoma Surgery Choroidal Detachment Scleral Flap 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Marlene R. Moster
    • 1
  • Augusto Azuara-Blanco
    • 2
  1. 1.Department of OphthalmologyThomas Jefferson University HospitalPhiladelphiaUSA
  2. 2.Department of OphthalmologyAberdeen Royal Infirmary, The Eye Clinic, University of AberdeenForesterhillUK

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