Indications And Outcomes Of Trabeculectomy At Pcea Kikuyu Hospital- Eye Unit; A Retrospective Study_Functional Outcome In Conservative Management Of Diaphyseal Humerus Fractures - A Comparative Assessment On The Use Of U Slab Vis-À-Vis Functional Brace

Abstract

Introduction and background: Trabeculectomy is the most common glaucoma surgery done at PCEA Kikuyu Hospital-Eye Unit (KEU), in Kenya and in the world. Few studies have been done looking at the indications and outcomes of the surgery in Kenya yet glaucoma remains the leading cause of irreversible blindness. Objectives: To determine the indications, outcomes, complications and factors affecting outcomes of trabeculectomy at PCEA Kikuyu Hospital-Eye Unit (KEU). Study design: Retrospective case series Study population: All patients who had trabeculectomy done in PCEA Kikuyu Hospital- Eye Unit from 1st January 2012 to 31st December 2016. Results: There were 318 eyes of 265 patients who were recruited into the study. The mean age of the participants was 56.5 years (SD ± 15.8). There were 164 (61.9%) males and 101 females (38.1%). Failed medical therapy was the most common indication in 165 eyes (60.1%) followed by advanced glaucoma in 60 eyes (22.1%). The mean pre-operative IOP (27.8mmHg) showed a remarkable drop compared to Day 1 mean post-operative IOP (7.6mmHg). The difference between the mean IOP pre-operative and post-operative was statistically significant (<0.05) at all follow up periods. There were 67.4% and 74.2% patients who achieved complete and qualified success at 1 year respectively while 56.1% and 66.3% achieved complete and qualified success respectively at 2 years post-operative. At final follow up, 31 eyes (9.7%) had failure. The most frequent early complication was shallow AC in 35 eyes (48.6%) and bleb leak in 22 eyes (30.6%) while cataract was the most frequent late complication in 41 eyes (87.2%). Age of patient, use of antimetabolite and type of glaucoma were not found to affect IOP outcomes of trabeculectomy in this study due to the low numbers in some of the groups. Conclusions: Failed medical therapy was the most common indication of trabeculectomy. Trabeculectomy is effective in reducing uncontrolled IOP up to 2 years post-operative. Shallow AC and hypotony were the most common early complications of trabeculectomy while bleb fibrosis and cataract were the most frequent late complications.