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Predictive value of early postoperative IOP and bleb morphology in Mitomycin-C augmented trabeculectomy

Loewen, NA and Esfandiari, H and Pakravan, M and Yaseri, M (2017) Predictive value of early postoperative IOP and bleb morphology in Mitomycin-C augmented trabeculectomy. F1000Research, 6. ISSN 2046-1402

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Abstract

© 2017 Esfandiari H et al. Background: To determine the predictive value of postoperative bleb morphological features and intraocular pressure (IOP) on the success rate of trabeculectomy. Methods: In this prospective interventional case series, we analyzed for one year 80 consecutive primary open angle glaucoma patients who underwent mitomycin-augmented trabeculectomy. Bleb morphology was scored using the Indiana bleb appearance grading scale (IBAGS). Success was defined as IOP ≤15 mmHg at 12 months. We applied a multivariable regression analysis and determined the area under the receiver operating characteristic curve (AUC). Results: The mean age of participants was 62±12.3 years in the success and 63.2±16.3 years in the failure group (P= 0.430) with equal gender distribution (P=0.911). IOPs on day 1, 7 and 30 were similar in both (P= 0.193, 0.639, and 0.238, respectively.) The AUC of IOP at day 1, day 7 and 30 for predicting a successful outcome was 0.355, 0.452, and 0.80, respectively. The AUC for bleb morphology parameters of bleb height, extension, and vascularization, on day 14 were 0.368, 0.408, and 0.549, respectively. Values for day 30 were 0.428, 0.563, and 0.654. IOP change from day 1 to day 30 was a good predictor of failure (AUC=0.838, 95% CI: 0.704 to 0.971) with a change of more than 3 mmHg predicting failure with a sensitivity of 82.5% (95% CI: 68 to 91%) and a specificity of 87.5% (95% CI: 53 to 98%). Conclusions: IOP on day 30 had a fair to good accuracy while bleb features failed to predict success except bleb vascularity that had a poor to fair accuracy. An IOP increase more than 3 mmHg during the first 30 days was a good predictor of failure.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Loewen, NAnal58@pitt.eduNAL58
Esfandiari, H
Pakravan, M
Yaseri, M
Date: 1 January 2017
Date Type: Publication
Journal or Publication Title: F1000Research
Volume: 6
DOI or Unique Handle: 10.12688/f1000research.12904.2
Schools and Programs: School of Medicine > Ophthalmology
Refereed: No
ISSN: 2046-1402
Date Deposited: 17 Mar 2017 17:46
Last Modified: 23 Jan 2018 20:55
URI: http://d-scholarship.pitt.edu/id/eprint/30973

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