The National Survey of Trabeculectomy. III. Early and late complications

Lorna (Beth) Edmunds, J. R. Thompson, J. F. Salmon, R. P. Wormald

Research output: Contribution to journalArticle

189 Citations (Scopus)

Abstract

Purpose There is a considerable body of literature relating to trabeculectomy, however there are no data representative of the national experience of trabeculectomy in the United Kingdom (UK). The Department of Health funded a national survey of trabeculectomy to establish current practice patterns and the outcome of trabeculectomy in the National Health Service (NHS). In this paper we present the reported complications of first-time trabeculectomy from a nationally representative cohort of patients with chronic open angle glaucoma. Methods Cross-sectional study of consultant ophthalmologists performing trabeculectomy in the NHS. Participants recruited their four most recent consecutive first-time trabeculectomy cases with chronic open angle glaucoma according to study eligibility criteria and data were collected by self-administered questionnaire. Follow-up: one year post-trabeculectomy. Main outcome measures: occurrence of early and late complications. Results: Clinical outcome data were available for 1240 (85.3%) of cases. Early complications were reported in 578 (46.6%) cases and late complications in 512 (42.3%) cases. Some cases had more than one complication. The most frequent early complications were hyphaema (n = 304, 24.6%), shallow anterior chamber (n = 296, 23.9%), hypotony (n = 296, 24.3%), wound leak (n = 216, 17.8%) and choroidal detachment (n = 175, 14.1%). The most frequent late complications were cataract (n = 251, 20.2%), visual loss (n = 230, 18.8%) and encapsulated bleb (n = 42, 3.4%). The occurrence of most complications was not associated with a consultant's specialist interest, level of activity, type of hospital or region. Encapsulated bleb was reported more frequently in a university hospital setting. Conclusions The complication rates reported in this paper represent the national experience of first-time trabeculectomy for open angle glaucoma in the UK. These are similar to previous published studies and highlight in particular, the impact of trabeculectomy on visual acuity in the first year following surgery. This survey provides valid and clinically relevant data on the complications of trabeculectomy for the production of guidelines and standards for audit at regional, local and individual level.

Original languageEnglish (US)
Pages (from-to)297-303
Number of pages7
JournalEye
Volume16
Issue number3
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Trabeculectomy
Open Angle Glaucoma
National Health Programs
Blister
Consultants
Surveys and Questionnaires
Hyphema
Patient Advocacy
Anterior Chamber
Cataract
Visual Acuity
Cross-Sectional Studies
Outcome Assessment (Health Care)
Guidelines

Keywords

  • Complications
  • National survey
  • Outcomes
  • Trabeculectomy
  • Visual loss

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

Cite this

The National Survey of Trabeculectomy. III. Early and late complications. / Edmunds, Lorna (Beth); Thompson, J. R.; Salmon, J. F.; Wormald, R. P.

In: Eye, Vol. 16, No. 3, 2002, p. 297-303.

Research output: Contribution to journalArticle

Edmunds, Lorna (Beth) ; Thompson, J. R. ; Salmon, J. F. ; Wormald, R. P. / The National Survey of Trabeculectomy. III. Early and late complications. In: Eye. 2002 ; Vol. 16, No. 3. pp. 297-303.
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N2 - Purpose There is a considerable body of literature relating to trabeculectomy, however there are no data representative of the national experience of trabeculectomy in the United Kingdom (UK). The Department of Health funded a national survey of trabeculectomy to establish current practice patterns and the outcome of trabeculectomy in the National Health Service (NHS). In this paper we present the reported complications of first-time trabeculectomy from a nationally representative cohort of patients with chronic open angle glaucoma. Methods Cross-sectional study of consultant ophthalmologists performing trabeculectomy in the NHS. Participants recruited their four most recent consecutive first-time trabeculectomy cases with chronic open angle glaucoma according to study eligibility criteria and data were collected by self-administered questionnaire. Follow-up: one year post-trabeculectomy. Main outcome measures: occurrence of early and late complications. Results: Clinical outcome data were available for 1240 (85.3%) of cases. Early complications were reported in 578 (46.6%) cases and late complications in 512 (42.3%) cases. Some cases had more than one complication. The most frequent early complications were hyphaema (n = 304, 24.6%), shallow anterior chamber (n = 296, 23.9%), hypotony (n = 296, 24.3%), wound leak (n = 216, 17.8%) and choroidal detachment (n = 175, 14.1%). The most frequent late complications were cataract (n = 251, 20.2%), visual loss (n = 230, 18.8%) and encapsulated bleb (n = 42, 3.4%). The occurrence of most complications was not associated with a consultant's specialist interest, level of activity, type of hospital or region. Encapsulated bleb was reported more frequently in a university hospital setting. Conclusions The complication rates reported in this paper represent the national experience of first-time trabeculectomy for open angle glaucoma in the UK. These are similar to previous published studies and highlight in particular, the impact of trabeculectomy on visual acuity in the first year following surgery. This survey provides valid and clinically relevant data on the complications of trabeculectomy for the production of guidelines and standards for audit at regional, local and individual level.

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