Effects of pre-surgical administration of prostaglandin analogs on the outcome of trabeculectomy

Takako Miki, Tomoko Naito, Miyuki Fujiwara, Ryoichi Araki, Rieko Kiyoi, Yusuke Shiode, Atsushi Fujiwara, Yuki Morizane, Fumio Shiraga

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

For primary open angle glaucoma (POAG), laser treatment or surgery is used when the target intraocular pressure (IOP) cannot be achieved by pharmacological agents, such as prostaglandin (PG) analogs; these drugs also have varied effects. We retrospectively reviewed the medical records of 74 POAG patients (74 eyes) whose IOP was inadequately controlled by PG analogs (bimatoprost [13 eyes], latanoprost [34 eyes], tafluprost [11 eyes], and travoprost [16 eyes]) and underwent primary trabeculectomy. The proportion of patients with no recurrent IOP elevation within 24 months post-trabeculectomy was significantly (P < 0.001) lower in the bimatoprost group (31.3%) than in the latanoprost (83.2%), tafluprost (45.5%), or travoprost groups (65.6%). Deepening of the upper eyelid sulcus (DUES) was observed before trabeculectomy in 18 of 74 eyes (24.3%) treated with bimatoprost (9 eyes; 50.0%), latanoprost (3 eyes; 16.7%), tafluprost (1 eye; 5.5%) and travoprost (5 eyes; 27.8%). The proportion of patients with no recurrent IOP elevation up to 24 months post-trabeculectomy was significantly (P < 0.0001) lower in the DUES(+) group (34.7%) than in the DUES(-) group (74.3%). Multivariate stepwise logistic regression analysis, with no recurrent IOP elevation used as dependent variable, and bimatoprost, latanoprost, travoprost, tafluprost, β-blocker, carbonic anhydrase inhibitor, brimonidine, gender, age, preoperative IOP, mean deviation, duration of PG analog use before surgery, and the number of ophthalmic solutions used as independent variables, identified only bimatoprost as a significant independent factor (P = 0.0368). Thus, the outcome of trabeculectomy varied depending on the PG analog used preoperatively, and bimatoprost use was associated with a high risk of recurrent IOP elevation up to 2 years post-trabeculectomy. This may indicate that the incidence of DUES differed with the PG analog used. Patients with glaucoma who are treated with bimatoprost should be monitored for DUES, and when these patients undergo trabeculectomy, the postoperative course of IOP should be followed carefully.

Original languageEnglish
Article numbere0181550
JournalPLoS One
Volume12
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

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synthetic prostaglandins
Synthetic Prostaglandins
Trabeculectomy
latanoprost
Intraocular Pressure
eyes
eyelids
Eyelids
glaucoma
Surgery
Carbonic Anhydrase Inhibitors
Ophthalmic Solutions
surgery
Bimatoprost
Regression analysis
Logistics
carbonate dehydratase
Glaucoma
angle of incidence
Medical Records

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Effects of pre-surgical administration of prostaglandin analogs on the outcome of trabeculectomy. / Miki, Takako; Naito, Tomoko; Fujiwara, Miyuki; Araki, Ryoichi; Kiyoi, Rieko; Shiode, Yusuke; Fujiwara, Atsushi; Morizane, Yuki; Shiraga, Fumio.

In: PLoS One, Vol. 12, No. 7, e0181550, 01.07.2017.

Research output: Contribution to journalArticle

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abstract = "For primary open angle glaucoma (POAG), laser treatment or surgery is used when the target intraocular pressure (IOP) cannot be achieved by pharmacological agents, such as prostaglandin (PG) analogs; these drugs also have varied effects. We retrospectively reviewed the medical records of 74 POAG patients (74 eyes) whose IOP was inadequately controlled by PG analogs (bimatoprost [13 eyes], latanoprost [34 eyes], tafluprost [11 eyes], and travoprost [16 eyes]) and underwent primary trabeculectomy. The proportion of patients with no recurrent IOP elevation within 24 months post-trabeculectomy was significantly (P < 0.001) lower in the bimatoprost group (31.3{\%}) than in the latanoprost (83.2{\%}), tafluprost (45.5{\%}), or travoprost groups (65.6{\%}). Deepening of the upper eyelid sulcus (DUES) was observed before trabeculectomy in 18 of 74 eyes (24.3{\%}) treated with bimatoprost (9 eyes; 50.0{\%}), latanoprost (3 eyes; 16.7{\%}), tafluprost (1 eye; 5.5{\%}) and travoprost (5 eyes; 27.8{\%}). The proportion of patients with no recurrent IOP elevation up to 24 months post-trabeculectomy was significantly (P < 0.0001) lower in the DUES(+) group (34.7{\%}) than in the DUES(-) group (74.3{\%}). Multivariate stepwise logistic regression analysis, with no recurrent IOP elevation used as dependent variable, and bimatoprost, latanoprost, travoprost, tafluprost, β-blocker, carbonic anhydrase inhibitor, brimonidine, gender, age, preoperative IOP, mean deviation, duration of PG analog use before surgery, and the number of ophthalmic solutions used as independent variables, identified only bimatoprost as a significant independent factor (P = 0.0368). Thus, the outcome of trabeculectomy varied depending on the PG analog used preoperatively, and bimatoprost use was associated with a high risk of recurrent IOP elevation up to 2 years post-trabeculectomy. This may indicate that the incidence of DUES differed with the PG analog used. Patients with glaucoma who are treated with bimatoprost should be monitored for DUES, and when these patients undergo trabeculectomy, the postoperative course of IOP should be followed carefully.",
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