Effects of early postoperative complications and the location of trephined block on long-term intraocular pressure control after trabeculectomy

Background. Complications of trabeculectomy in eyes with primary open-angle glaucoma (POAG) and exfoliation glaucoma (EG) were compared. The effects of complications and the location of the trephined tissue block on the long-term success were evaluated. Methods. One hundred thirty-eight consecutive eyes with POAG or EG of patients over 40 years of age operated on by one surgeon by trabeculectomy without using antimetabolites were analyzed retrospectively. Early postoperative complications and any additional postoperative procedures were recorded and related to the final outcome. In 118 eyes the location of the trephined tissue block was defined in a light microscopic study as anterior or posterior. The success rates in these two groups were determined by Kaplan-Meier survival curves, and the complication rates were compared. Results. Postoperative complications were equally common in POAG and EG, except for hyphema, which was significantly more common in EG than in POAG. Of the early complications, only insufficient filtration at the end of the 1st postoperative month was significantly associated with failure in the long term. The location of trabeculectomy did not significantly affect the early postoperative complications or the long-term success. Conclusions. Early postoperative complications after trabeculectomy were common, but the only significant predictor of failure was increased intraocular pressure at the end of the 1st postoperative month.