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¹M.D., Beyoğlu Training and Research Hospital, 1st Eye Clinic, İstanbul/TURKEY
²M.D. Asistant, Beyoğlu Training and Research Hospital, 1st Eye Clinic, İstanbul/TURKEY
³M.D. Associate Professor, Beyoğlu Training and Research Hospital, 1st Eye Clinic, İstanbul/TURKEY
⁴M.D. Professor, Beyoğlu Training and Research Hospital, 1st Eye Clinic, İstanbul/TURKEY Purpose: To investigate the incidence and risk factors for the development of encapsulated bleb (EB) following trabeculectomy.
Materials and Methods: Records of patients who underwent trabeculectomy between July 2009 and January 2011 and who were followed-up for at least 3 months were investigated. Juvenile glaucoma, secondary glaucoma such as neovascular glaucoma, uveitic glaucoma, and combined surgeries were excluded. Ninety-eight eyes of 90 consecutive patients were included. Age, sex, systemic disease, glaucoma type, visual acuity (VA), preoperative intraocular pressure (IOP), preoperative antiglaucoma medications, history of intraocular surgery and laser, intraoperative mitomycin-C (MMC) use, type of conjunctival flap postoperative IOP, and postoperative number of glaucoma medications were recorded. A localized, elevated, tense, dome-shaped bleb with prominent surface vessels was accepted as EB. Two groups of eyes with or without EB were compared.
Results: EB was detected in 21 of 98 eyes (21.4%) following trabeculectomy. The mean follow-up time was 8.3±5.4 months. There were no difference in terms of age, sex, glaucoma type, preoperative IOP, or preoperative VA between the groups (p>0.05). Mean number of preoperative antiglaucomatous medications was 3.76±0.54 in group 1 and 3.45±0.65 in group 2 (p=0.04). There was no significant difference between the groups in use of preoperative antiglaucomatous drugs such as carbonic anhydrase inhibitors, β blockers, and prostaglandin analogs; however, increased prevalence of preoperative alpha mimetic use was detected in group 1 (p<0.05). EB was detected in 13 of 62 eyes that underwent the limbal-based conjunctival flap technique, in 8 of 36 eyes that underwent the fornix-based conjunctival flap technique, in 14 of 63 eyes that underwent trabeculectomy with intraoperative application of MMC, and in 7 of 35 eyes that underwent trabeculectomy without MMC (p>0.05 for each).
Conclusion: Increased preoperative antiglaucoma medication use and prevalence of preoperative alpha mimetic use were associated with EB development following trabeculectomy. Keywords : Trabeculectomy, encapsulated bleb