Journal Reading

DOKTER MUDA MATA

Rabu, 13 Desember 2016
Pukul 11.00 12.00 WIB
Anggota:

M.Satria
Syifa Riswanda
Risa Rahmasari
Rahmat Ikbal
Almira Ismaryadi
Amalia Noor Zafira

Journal Reading
DOKTER MUDA MATA
Rabu, 13 Desember 2016

RISK OF ENDOPHTALMITIS AND OTHER

LONG TERM COMPLICATIONS OF
TRABECULECTOMY IN THE
COLLABORATIVE INITIAL GLAUCOMA
TREATMENT STUDY (CIGTS)
Sarwar Zahid, David C.Musch, Leslie M.Niziol, and Paul R.Lichter
on behalf of the collaborative initial glaucoma treatment study
group.
From the Kellog Eye Center, Department of Ophtalmology Visual Sciences,
University of Michigan, Ann Arbor, Michigan, and Department of Epidemiology,
School of Public Health, University of Michigan, Ann Arbor, Michigan.
Am J Ophtalmol 2013; 155: 675-680 2013 by Elsevier Inc. All rights reserved .

INTRODUCTION
Trabeculectomy is the most penetrating surgical intervention
for the treatment of open-angle glaucoma

Although this filtering surgical procedure has

been used widely over the past several
decades, the concern for complications of
filtering surgery especially endophtalmitis
has given rise

Other prospective population based study in the UK

estimated the
Incidence per year of blebitis with bleb leak and
endhophtalmitis
After trabeculectomy at 0.11% and 0.17% respectively

METHODS
The sutdy was approved by the University of Michigan
Institutional of Review Board and 14 clinical centers,
involved 36 surgeons

The study endrolled 607 patients with newly

open angle glaucoma

Other prospective population based study in the UK

estimated the
Incidence per year of blebitis with bleb leak and
endhophtalmitis
After trabeculectomy at 0.11% and 0.17% respectively

METHODS
Intraoperative or postoperative use of 5-fluorouracil was
permitted in the initial trabeculectomy procedure.

Follow up were conducted at 3 and 6 months

after the treatment began and 6 month
intervals thereafter.

Data on complications occuring beyond 1 month after

surgery were collected from standardized forms, which
listed a finite number of specific complications . After
tabulation of the frequencies of complications using
descriptive statistics, the data were assesed by KaplanMeier survival curves, analyzed by SAS software version

RESULTS

RESULTS

RESULTS

DISCUSSION
1. For surgical approaches to treating OAC with the potential
for infectious complications, an adequate assesment risk
is critical
2. There is a theoretically reduced risk of infection in non
penetrating glaucoma surgery, compared to
trabeculectomy
3. Comparisons between nonpeneterating glaucoma surgery
and conventional trabeculectomy so far have been limited
by sample sizes and limited follow up, although many
have suggested better IOP-lowering efficacy in
conventional trabeculectomy
4. More data: suggest superior efficacy with conventional
trabeculectomy, especially with respect to IOP reduction,
although non-peneterating surgery exhibited fewer
complications. However, the autors do not specify which
complications occurred less frequently in nonpenetrating
surgery
5. Although overal postoperative complications were higher
in the trabeculectomy group, most of those complications

DISCUSSION
7. Endophtalmitis was found in 3 of 285 patients (1,1%) who
underwent initial trabeculectomy
8. 2 of 3 patients were reported as having a bleb leak with
blebitis requiring hospitalization and did not exhibit a
dramatic reduction in VA
9. Adalah sangat penting untuk mencatat bahwa tidak ada
dari ketiga pasien ini yang mengalami gejala infeksi
seperti pada protokol uang telah ditetapkan
10.Selama 84 bulan follow-up, baru ditemui bleb, dimana
diduga sebagai faktor kuat untuk endoftalmitis (141
pasien)
11.Given that 8 patients were reported to had blebitis, and
only 3 (or fewer) to have endophtalmitis, Risk of
endophtalmitis: 1.1%
12.None of the patients with bleb-related complications or
endophtalmitis were given MMC, alhthough were given 5FU
13.Occurrence of these complications was not statistically
associated qith 5-FU use

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