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Japanese Journal of Ophthalmology
Published in: Japanese Journal of Ophthalmology 6/2016

01-11-2016 | Clinical Investigation

Influence of high myopia on outcomes of trabeculectomy with mitomycin C in patients with primary open-angle glaucoma

Authors: Daisuke Tanaka, Hideo Nakanishi, Masanori Hangai, Tadamichi Akagi, Satoshi Morooka, Hanako Ohashi Ikeda, Nagahisa Yoshimura

Published in: Japanese Journal of Ophthalmology | Issue 6/2016

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Abstract

Purpose

To determine the clinical characteristics and surgical outcomes of highly myopic (HM) eyes with an axial length (AL) of ≥26.0 mm that underwent trabeculectomy with mitomycin C (MMC).

Methods

This was a retrospective study of 63 eyes of 54 patients with primary open-angle glaucoma that underwent trabeculectomy with MMC. The characteristics and surgical outcomes of 19 HM eyes were compared with those of 44 non-HM eyes. Surgical success was defined as an high intraocular pressure (IOP) of ≤21 mmHg (criterion A), ≤18 mmHg (criterion B), or ≤15 mmHg (criterion C), with a lower IOP cutoff of 6 mmHg and a >20 % reduction regardless of the use of antiglaucoma medication. Cox regression analyses were performed to evaluate the effect of each pretreatment and surgical factor on the success rate.

Results

Patients with HM eyes were significantly younger than those with non-HM eyes (mean age 64.1 ± 9.9 vs. 69.1 ± 9.5 years; P < 0.05). The 3-year qualified success rates for HM eyes and non-HM eyes did not differ significantly for the three criteria. Younger age [hazard ratio (HR) for a 1-year increase 0.93, P < 0.005], preoperative pseudophakia (HR 3.88, P < 0.005), and shorter AL (HR for a 1-mm increase 0.72, P < 0.05) were found to be significant risk factors for trabeculectomy failure based on an IOP of ≤15 mmHg (criterion C). Age and pseudophakia also had significant effects on trabeculectomy failure based on criteria A and B, and the AL had a significant influence based on criterion A.

Conclusions

In our patient cohort a longer AL was not a risk factor for trabeculectomy failure, but it may be a success factor for trabeculectomy with MMC.
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Literature
1.
Bourne RR, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, et al. Causes of vision loss worldwide, 1990–2010: a systematic analysis. Lancet Glob Heal. 2013;1:e339–49.CrossRef
2.
Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121:2081–90.CrossRefPubMed
3.
Mitchell P, Hourihan F, Sandbach J, Wang JJ. The relationship between glaucoma and myopia: the Blue Mountains Eye Study. Ophthalmology. 1999;106:2010–5.CrossRefPubMed
4.
Wu SY, Nemesure B, Leske MC. Refractive errors in a black adult population: the Barbados Eye Study. Invest Ophthalmol Vis Sci. 1999;40:2179–84.PubMed
5.
Wong TY, Klein BE, Klein R, Knudtson M, Lee KE. Refractive errors, intraocular pressure, and glaucoma in a white population. Ophthalmology. 2003;110:211–7.CrossRefPubMed
6.
Suzuki Y, Iwase A, Araie M, Yamamoto T, Abe H, Shirato S, et al. Risk factors for open-angle glaucoma in a Japanese population: the Tajimi Study. Ophthalmology. 2006;113:1613–7.CrossRefPubMed
7.
Xu L, Wang Y, Wang S, Wang Y, Jonas JB. High myopia and glaucoma susceptibility: the Beijing Eye Study. Ophthalmology. 2007;114:216–20.CrossRefPubMed
8.
Czudowska MA, Ramdas WD, Wolfs RC, Hofman A, De Jong PT, Vingerling JR, et al. Incidence of glaucomatous visual field loss: a ten-year follow-up from the Rotterdam study. Ophthalmology. 2010;117:1705–12.CrossRefPubMed
9.
Perera SA, Wong TY, Tay WT, Foster PJ, Saw SM, Aung T. Refractive error, axial dimensions, and primary open-angle glaucoma: the Singapore Malay Eye Study. Arch Ophthalmol. 2010;128:900–5.CrossRefPubMed
10.
Wong TY, Foster PJ, Ng TP, Tielsch JM, Johnson GJ, Seah SK. Variations in ocular biometry in an adult Chinese population in Singapore: the Tanjong Pagar Survey. Invest Ophthalmol Vis Sci. 2001;42:73–80.PubMed
11.
Shufelt C, Fraser-Bell S, Ying-Lai M, Torres M, Varma R. Refractive error, ocular biometry, and lens opalescence in an adult population: the Los Angeles Latino Eye Study. Invest Ophthalmol Vis Sci. 2005;46:4450–60.CrossRefPubMed
12.
Jacobi FK, Zrenner E, Broghammer M, Pusch CM. A genetic perspective on myopia. Cell Mol Life Sci. 2005;62:800–8.CrossRefPubMed
13.
14.
15.
Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:701–13.CrossRefPubMed
16.
Collaborative Normal-Tension Glaucoma Study Group. The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Am J Ophthalmol. 1998;126:498–505.CrossRef
17.
Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M, et al. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002;120:1268–79.CrossRefPubMed
18.
The AGIS Investigators. The advanced glaucoma intervention study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol. 2000;130:429–40.CrossRef
19.
Garway-Heath DF, Crabb DP, Bunce C, Lascaratos G, Amalfitano F, Anand N, et al. Latanoprost for open-angle glaucoma (UKGTS): a randomised, multicentre, placebo-controlled trial. Lancet. 2015;385:1295–304.CrossRefPubMed
20.
Fontana H, Nouri-Mahdavi K, Lumba J, Ralli M, Caprioli J. Trabeculectomy with mitomycin C: outcomes and risk factors for failure in phakic open-angle glaucoma. Ophthalmology. 2006;113:930–6.CrossRefPubMed
21.
Fontana H, Nouri-Mahdavi K, Caprioli J. Trabeculectomy with mitomycin C in pseudophakic patients with open-angle glaucoma: outcomes and risk factors for failure. Am J Ophthalmol. 2006;141:652–9.CrossRefPubMed
22.
Shigeeda T, Tomidokoro A, Chen YN, Shirato S, Araie M. Long-term follow-up of initial trabeculectomy with mitomycin C for primary open-angle glaucoma in Japanese patients. J Glaucoma. 2006;15:195–9.CrossRefPubMed
23.
Law SK, Shih K, Tran DH, Coleman AL, Caprioli J. Long-term outcomes of repeat vs initial trabeculectomy in open-angle glaucoma. Am J Ophthalmol. 2009;148(685–95):e1.PubMed
24.
Jampel HD, Solus JF, Tracey PA, Gilbert DL, Loyd TL, Jefferys JL, et al. Outcomes and bleb-related complications of trabeculectomy. Ophthalmology. 2012;119:712–22.CrossRefPubMed
25.
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.CrossRefPubMed
26.
The AGIS Investigators. The Advanced Glaucoma Intervention Study (AGIS): 11. Risk factors for failure of trabeculectomy and argon laser trabeculoplasty. Am J Ophthalmol. 2002;134:481–98.CrossRef
27.
Grehn F, Holló G, Khaw P, Overton B, Wilson R, Vogel R, et al. Factors affecting the outcome of trabeculectomy: an analysis based on combined data from two phase III studies of an antibody to transforming growth factor beta2, CAT-152. Ophthalmology. 2007;114:1831–8.CrossRefPubMed
28.
Broadway D, Grierson I, Hitchings R. Racial differences in the results of glaucoma filtration surgery: are racial differences in the conjunctival cell profile important? Br J Ophthalmol. 1994;78:466–75.CrossRefPubMedPubMedCentral
29.
The AGIS Investigators. The Advanced Glaucoma Intervention Study (AGIS): 9. Comparison of glaucoma outcomes in black and white patients within treatment groups. Am J Ophthalmol. 2001;132:311–20.CrossRef
30.
Broadway DC, Chang LP. Trabeculectomy, risk factors for failure and the preoperative state of the conjunctiva. J Glaucoma. 2001;10:237–49.CrossRefPubMed
31.
Takihara Y, Inatani M, Seto T, Iwao K, Iwao M, Inoue T, et al. Trabeculectomy with mitomycin for open-angle glaucoma in phakic vs pseudophakic eyes after phacoemulsification. Arch Ophthalmol. 2011;129:152–7.CrossRefPubMed
32.
Takihara Y, Inatani M, Ogata-Iwao M, Kawai M, Inoue T, Iwao K, et al. Trabeculectomy for open-angle glaucoma in phakic eyes vs in pseudophakic eyes after phacoemulsification: a prospective clinical cohort study. JAMA Ophthalmol. 2014;132:69–76.CrossRefPubMed
33.
Sugimoto Y, Mochizuki H, Ohkubo S, Higashide T, Sugiyama K, Kiuchi Y. Intraocular pressure outcomes and risk factors for failure in the Collaborative Bleb-Related Infection Incidence and Treatment Study. Ophthalmology. 2015;122:2223–33.CrossRefPubMed
34.
Shin YJ, Nam WH, Park SE, Kim JH, Kim HK. Aqueous humor concentrations of vascular endothelial growth factor and pigment epithelium-derived factor in high myopic patients. Mol Vis. 2012;18:2265–70.PubMedPubMedCentral
35.
Jia Y, Hu DN, Zhou J. Human aqueous humor levels of TGF-β2: relationship with axial length. Biomed Res Int. 2014;2014:258591.PubMedPubMedCentral
36.
Zhu X, Zhang K, He W, Yang J, Sun X, Jiang C, et al. Proinflammatory status in the aqueous humor of high myopic cataract eyes. Exp Eye Res. 2016;142:13–8.CrossRefPubMed
37.
38.
Kanda Y. Investigation of the freely available easy-to-use software EZR for medical statistics. Bone Marrow Transplant. 2013;48:452–8.CrossRefPubMed
39.
Inatani M, Tanihara H, Katsuta H, Honjo M, Kido N, Honda Y. Transforming growth factor-β2 levels in aqueous humor of glaucomatous eyes. Graefe’s Arch Clin Exp Ophthalmol. 2001;239:109–13.CrossRef
40.
Picht G, Welge-Luessen U, Grehn F, Lütjen-Drecoll E. Transforming growth factor beta 2 levels in the aqueous humor in different types of glaucoma and the relation to filtering bleb development. Graefes Arch Clin Exp Ophthalmol. 2001;239:199–207.CrossRefPubMed
41.
Sawada H, Fukuchi T, Tanaka T, Abe H. Tumor necrosis factor-alpha concentrations in the aqueous humor of patients with glaucoma. Invest Ophthalmol Vis Sci. 2010;51:903–6.CrossRefPubMed
42.
Inoue T, Kawaji T, Inatani M, Kameda T, Yoshimura N, Tanihara H. Simultaneous increases in multiple proinflammatory cytokines in the aqueous humor in pseudophakic glaucomatous eyes. J Cataract Refract Surg. 2012;38:1389–97.CrossRefPubMed
43.
Takai Y, Tanito M, Ohira A. Multiplex cytokine analysis of aqueous humor in eyes with primary open-angle glaucoma, exfoliation glaucoma, and cataract. Invest Ophthalmol Vis Sci. 2012;53:241–7.CrossRefPubMed
44.
Engel LA, Muether PS, Fauser S, Hueber A. The effect of previous surgery and topical eye drops for primary open-angle glaucoma on cytokine expression in aqueous humor. Graefe’s Arch Clin Exp Ophthalmol. 2014;252:791–9.CrossRef
45.
Shingleton BJ, Alfano C, O’Donoghue MW, Rivera J. Efficacy of glaucoma filtration surgery in pseudophakic patients with or without conjunctival scarring. J Cataract Refract Surg. 2004;30:2504–9.CrossRefPubMed
46.
Supawavej C, Nouri-Mahdavi K, Law SK, Caprioli J. Comparison of results of initial trabeculectomy with mitomycin C after prior clear-corneal phacoemulsification to outcomes in phakic eyes. J Glaucoma. 2013;22:52–9.CrossRefPubMed
47.
Rebolleda G, Muñoz-Negrete FJ. Phacoemulsification in eyes with functioning filtering blebs: a prospective study. Ophthalmology. 2002;109:2248–55.CrossRefPubMed
48.
Husain R, Liang S, Foster PJ, Gazzard G, Bunce C, Chew PT, et al. Cataract surgery after trabeculectomy: the effect on trabeculectomy function. Arch Ophthalmol. 2012;130:165–70.CrossRefPubMed
49.
Edmunds B, Thompson JR, Salmon JF, Wormald RP, Thompson JR, Salmon JF. The National Survey of Trabeculectomy. II. Variations in operative technique and outcome. Eye. 2001;15:441–8.CrossRefPubMed
Metadata
Title
Influence of high myopia on outcomes of trabeculectomy with mitomycin C in patients with primary open-angle glaucoma
Authors
Daisuke Tanaka
Hideo Nakanishi
Masanori Hangai
Tadamichi Akagi
Satoshi Morooka
Hanako Ohashi Ikeda
Nagahisa Yoshimura
Publication date
01-11-2016
Publisher
Springer Japan
Published in
Japanese Journal of Ophthalmology / Issue 6/2016
Print ISSN: 0021-5155
Electronic ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-016-0468-7

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