Trabeculectomy Outcomes and Predictive Factors for Surgical Failure in Glaucoma Patients at a Tertiary Hospital, Northern Tanzania
Judith Fanuel Malekela *
Department of Ophthalmology, KCMC University, Kilimanjaro, Tanzania.
Maria Goodhope Kissanga
Department of Ophthalmology, KCMC University, Kilimanjaro, Tanzania and Department of Ophthalmology, Kilimanjaro Christian Medical Centre, Tanzania.
Einoti Matayan
Department of Ophthalmology, KCMC University, Kilimanjaro, Tanzania and Department of Ophthalmology, Kilimanjaro Christian Medical Centre, Tanzania.
*Author to whom correspondence should be addressed.
Abstract
Aim: To evaluate long term outcomes of trabeculectomy and associated factors for failure among adult glaucoma patients in northern Tanzania from January 2013 to December 2023.
Study Design: This was a hospital based retrospective cohort study.
Place and Duration of Study: Department of Ophthalmology, Kilimanjaro Christian Medical Center, Northern Tanzania, between January 2013 and December 2023.
Methodology: This study included 286 eyes from 247 adult glaucoma patients aged ≥18 years who underwent primary trabeculectomy (TE), with or without cataract surgery. Data were consecutively extracted from medical records. Surgical success was defined as postoperative intraocular pressure (IOP) between 6 and 21 mmHg. Data were analyzed using STATA 17.
Results: The median (IQR) age at surgery was 63 years (range, 53–71). Mean (±SD) follow up time was 11 (±1.4) months. The surgical success rate was 84.2% at 12 months. The median (IQR) IOP was reduced from 30 (17-58) mmHg at baseline to 12 (7-31) mmHg, (P < 0.001) at 12-months post operatively. High baseline IOP (Hazard ratio = 1.72, P = 0.037) and older age at operation (Hazard ratio = 2.22, P = 0.008) were the only significant risk factors associated with a higher likelihood of trabeculectomy failure.
Conclusion: Trabeculectomy has shown higher success rates within 12-months among adult glaucoma patients in northern Tanzania. Achieving favorable outcomes in lowering IOP and reducing the number of medications.
Keywords: Trabeculectomy, intraocular pressure, surgical success rate, glaucoma