Published date: Dec 31 2024

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: Oct–Dec 2024, Volume 19, Issue 4

Pages: 421 – 432

DOI: 10.18502/jovr.v19i4.13881

Maryam Yadgarimaryam.yadgari@yahoo.ieOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Kiana Hassanpourkiana.hassanpour@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Fatemeh Vafaeifateme.vafaei86@gmail.comBasir Eye Health Research Center, Iran University of Medical Science, Tehran, Iran

Nina Firoozianninafiroozian@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Maryam Oraee Yazdanimaryam_o_yazdani@yahoo.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Zahra KhorramOphthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Sadid Hooshmandisadidhooshmandi@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Purpose: This study aims to assess the incidence of serous choroidal detachment (SCD) in the second eye of patients undergoing bilateral trabeculectomy (BT) and evaluate its impact on the clinical outcomes and failure rate of trabeculectomy in the second-operated eyes.
Methods: This retrospective case–control study analyzed 90 eyes of 45 patients who underwent BT. Surgical success was defined as maintaining intraocular pressure (IOP) between 5 and 21 mmHg, requiring no additional glaucoma surgery, and exhibiting a visual acuity of at least light perception. Relevant patient data, such as age, glaucoma type, systemic diseases, preoperative and postoperative IOP, and complications, were extracted from medical records.
Results: The mean age of patients was 59.8 ± 11.1 years. The five-year cumulative probability of success in the first- and second-operated eyes was 61.0% and 67.6%, respectively (log rank = 0.085, P = 0.77). Among the participants, 28.9% experienced SCD, and 76.9% of those who had SCD in the first-operated eye developed the same condition in the second eye as well (P < 0.001). In the first-operated eyes, the five-year cumulative probability of survival was 71.7% without SCD and 35.0% with SCD (log rank = 2.59, P = 0.107).
Conclusion: The occurrence of SCD in the first eye following trabeculectomy may indicate a predisposition to its development in the second eye during BT. Furthermore, the surgical success rate of the second-operated eye is comparable to the outcomes of the first eye undergoing BT.

Keywords: Bilateral, Serous Choroidal Detachment, Trabeculectomy

1. Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet 2004;363:1711–1720.

2. Nickells RW, Howell GR, Soto I, John SW. Under pressure: Cellular and molecular responses during glaucoma, a common neurodegeneration with axonopathy. Annu Rev Neurosci 2012;35:153–179.

3. McKean-Cowdin R, Wang Y, Wu J, Azen SP, Varma R, Group LALES. Impact of visual field loss on health-related quality of life in glaucoma: The Los Angeles Latino Eye Study. Ophthalmology 2008;115:941-8. e1.

4. Boland MV, Ervin AM, Friedman DS, Jampel HD, Hawkins BS, Vollenweider D, et al. Comparative effectiveness of treatments for open-angle glaucoma: A systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2013;158:271–279.

5. Savage JA. Glaucoma filtration surgery: Techniques and intraoperative complications. Clinical guide to glaucoma management Woburn. MA: Butterworth Heinemann; 2004. pp. 424–464.

6. Bhatia J. Outcome of trabeculectomy surgery in primary open angle glaucoma. Oman Med J 2008;23:86–89.

7. Stead RE, King AJ. Outcome of trabeculectomy with mitomycin C in patients with advanced glaucoma. Br J Ophthalmol 2011;95:960–965.

8. Gedde S, Herndon L, Brandt J, Budenz D, Feuer W, Schiffman J. Tube versus trabeculectomy study group. Postoperative outcomes in the tube versus trabeculectomy (TVT) study during five years of follow-up. Am J Ophthalmol 2012;153:804–814.

9. Landers J, Martin K, Sarkies N, Bourne R, Watson P. A twenty-year follow-up study of trabeculectomy: Risk factors and outcomes. Ophthalmology 2012;119:694–702.

10. Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol 1996;80:389–393.

11. Kanski Jack J, Brad B. Clinical ophthalmology-A systematic approach. Butterworth-Heinemann; 2007.

12. Jung Y, Park HY, Lee NY, Yoo YS, Park CK. Difference in outcomes between first-operated vs. fellow-operated eyes in patients undergoing bilateral Trabeculectomies. PLoS One 2015;10:e0136869.

13. Iwasaki K, Takamura Y, Nishida T, Sawada A, Iwao K, Shinmura A, et al. Comparing trabeculectomy outcomes between first and second operated eyes: A multicenter study. PLoS One 2016;11:e0162569.

14. Yadgari M, Hassanpour K, Nassiri N. Is posttrabeculectomy serous choroidal detachment a risk factor for failure in the long term. Eur J Ophthalmol 2022;32:282–287.

15. Sit AJ, McLaren JW. Measurement of episcleral venous pressure. Exp Eye Res 2011;93:291–298.

16. Schrieber C, Liu Y. Choroidal effusions after glaucoma surgery. Curr Opin Ophthalmol 2015;26:134–142.

17. Jampel HD, Musch DC, Gillespie BW, Lichter PR, Wright MM, Guire KE; Collaborative Initial Glaucoma Treatment Study Group. Perioperative complications of trabeculectomy in the collaborative initial glaucoma treatment study (CIGTS). Am J Ophthalmol 2005;140:16–22.

18. Feiner L, Piltz-Seymour JR; Collaborative Initial Glaucoma Treatment Study. Collaborative Initial Glaucoma Treatment Study: A summary of results to date. Curr Opin Ophthalmol 2003;14:106–111.

19. Haga A, Inatani M, Shobayashi K, Kojima S, Inoue T, Tanihara H. Risk factors for choroidal detachment after trabeculectomy with mitomycin C. Clin Ophthalmol 2013;7:1417–1421.

20. Berke SJ, Bellows AR, Shingleton BJ, Richter CU, Hutchinson BT. Chronic and recurrent choroidal detachment after glaucoma filtering surgery. Ophthalmology 1987;94:154–162.

21. Altan C, Ozturker C, Bayraktar S, Eren H, Ozturker ZK, Yilmaz OF. Post-trabeculectomy choroidal detachment: Not an adverse prognostic sign for either visual acuity or surgical success. Eur J Ophthalmol 2008;18:771–777.

22. Iwasaki K, Kakimoto H, Arimura S, Takamura Y, Inatani M. Prospective cohort study of risk factors for choroidal detachment after trabeculectomy. Int Ophthalmol 2020;40:1077–1083.

23. Mietz H, Jacobi PC, Welsandt G, Krieglstein GK. Trabeculectomies in fellow eyes have an increased risk of tenon’s capsule cysts. Ophthalmology 2002;109:992–997.

24. Kiessling D, Rennings C, Hild M, Lappas A, Dietlein TS, Roessler GF, et al. Predictability of ab-interno trabeculectomy success in the subsequent eye: Acontralateral eye comparison study. Clin Exp Ophthalmol 2021;49:242–250.

25. Zalish M, Oron Y, Geyer O. Outcome of consecutive trabeculectomy. Clin Exp Ophthalmol 2004;32:19–22.

26. Starita RJ, Fellman RL, Spaeth GL, Poryzees EM, Greenidge KC, Traverso CE. Short- and long-term effects of postoperative corticosteroids on trabeculectomy. Ophthalmology 1985;92:938–946.

27. Araujo SV, Spaeth GL, Roth SM, Starita RJ. A tenyear follow-up on a prospective, randomized trial of postoperative corticosteroids after trabeculectomy. Ophthalmology 1995;102:1753–1759.

28. Mahale A, Fikri F, Al Hati K, Al Shahwan S, Al Jadaan I, Al Katan H, et al. Histopathologic and immunohistochemical features of capsular tissue around failed Ahmed glaucoma valves. PLoS One 2017;12:e0187506.

29. Sacchi M, Monsellato G, Villani E, Lizzio RA, Cremonesi E, Luccarelli S, et al. Intraocular pressure control after combined phacotrabeculectomy versus trabeculectomy alone. Eur J Ophthalmol 2022;32:327–335.

30. L Jung J, Isida-Llerandi CG, Lazcano-Gomez G, SooHoo JR, Kahook MY; J LJ. Intraocular pressure control after trabeculectomy, phacotrabeculectomy and phacoemulsification in a Hispanic population. J Curr Glaucoma Pract 2014;8:67–74.

31. Wang M, Fang M, Bai YJ, Zhang WZ, Lin MK, Liu BQ, et al. Comparison of combined phacotrabeculectomy with trabeculectomy only in the treatment of primary angleclosure glaucoma. Chin Med J (Engl) 2012;125:1429–1433.

32. Choy BN. Comparison of surgical outcome of trabeculectomy and phacotrabeculectomy in Chinese glaucoma patients. Int J Ophthalmol 2017;10:1928–1930.