Tariq Jalal, Shad Mohammad.
Three years retrospective study of patients undergone Trabeculectomy in Lady Reading Hospital Peshawar.
J Postgrad Med Inst Jan ;18(3):487-94.

Objectives: To know the effect of trabeculectomy on controlling intra ocular pressure (IOP) and thus glaucoma progression and the final visual outcome of the patient. Material and Methods: A descriptive study of trabeculectomies performed for different types of glaucoma, during a period of three years (from Jan. 2000 to Dec. 2002) in Ophthalmology Unit of Postgraduate Medical Institute, Lady Reading Hospital, Peshawar was carried out. Trabeculectomies performed on all ages were included. A proforma was made showing name, age, sex, file number and diagnosis. Preoperative and postoperative visual acuity and I.O.P. recorded. Any postoperative complication was also noted. The use of Mitomycin-C was also noted which was restricted only to failed trabeculectomy and younger patients. Results: Trabeculectomy was performed on 232 eyes of 191 patients. About 85% of patients were above 40 years of age. The most common type of glaucoma was open angle glaucoma accounting for 51.31% with male predominance followed by angle closure glaucoma 40.32% with female predominance. Congenital glaucoma and steroid induced glaucoma were present in 4.71% and 3.66% of patient respectively and these were present in younger patients. Mitomycin-C was used in 10.78% patients. Visual acuity after trabeculectomy remained unchanged in 69.86%, improved in 17.35% and deteriorated in 12.79%. Postoperative IOP below 15 mmHg was found in 72.41% showing a good success rate, 23.7% patient has IOP between 16-20 mmHg and only 3.88% patient had IOP above 20mmHg. Shallow anterior chamber after trabeculectomy was found in 27.59% and hyphema in 6.47% both of which usually relieved in few days after conservative therapy. Postoperative endophthalmitis was not noted in any case. Conclusion: Trabeculectomy is still one of the most used approaches for surgical reduction of IOP. Primary trabeculectomy is a better method for cases in which a larger reduction in IOP is the aim of the treatment, especially in glaucoma patients who can not afford costly medicines, having poor compliance and still having high IOP despite maximum tolerable anti glaucoma medication

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