Difference in Outcomes between First-Operated vs. Fellow-Operated Eyes in Patients Undergoing Bilateral Trabeculectomies

• Published in: PloS one Vol. 10; no. 8; p. e0136869
• Main Authors: Jung, Younhea, Park, Hae-Young L, Lee, Na Young, Yoo, Young-Sik, Park, Chan Kee
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 28-08-2015; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Care and treatment; Colon; Development and progression; Eye; Failure analysis; Failure rates; Female; Genetic aspects; Glaucoma; Glaucoma - physiopathology; Glaucoma - surgery; Hospitals; Humans; Inflammation; Inflammatory response; Intraocular Pressure; Male; Medicine; Middle Aged; Patients; Racial differences; Reoperation; Risk factors; Science; Studies; Success; Surgeons; Surgery; Trabeculectomy - methods; Treatment Outcome; Wound healing; United States; Edinburgh Scotland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0136869

To compare the course and outcome of first- and fellow-operated eyes in patients who underwent bilateral trabeculectomies and to investigate the factors associated with the difference.
Preoperative characteristics, including the interval between surgeries, were compared between the first- and fellow-operated eyes in 42 patients who underwent bilateral trabeculectomies. Postoperative intraocular pressure and bleb vascularity, using postoperative anterior segment photos, were compared at various time points between the first- and fellow-operated eyes. Surgical success was evaluated at 1 year after surgery and at the final follow-up. Factors affecting the difference between the first and fellow eyes were analyzed.
There was no significant difference in success or failure rates at 1 year postoperatively and at the final follow-up between the first- and fellow-operated eyes. Early postoperative IOP and the degree of bleb vascularity were higher in the fellow-operated eyes (P = 0.001 and 0.003, respectively at week 1 postoperative). The difference in IOP between the first- and fellow-operated eyes was greater in patients whose interval between surgeries was shorter than 3 weeks (P = 0.026).
In patients undergoing bilateral trabeculectomies, early postoperative IOP was higher in the fellow-operated eyes than the first-operated eyes; the difference was greater when the interval between surgeries was shorter. The first-operated eye may influence the early postoperative inflammatory response in the fellow-operated eye. Our findings have clinical implications for planning treatment of patients who may need bilateral surgery.