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AbstractDO.16.06 Postoperative intervention one year after application of subconjunctival Triamcinolone acetonide during goniotrepanation Eylers T., Heinz C., Heiligenhaus A., Koch J. M.
Augenabteilung des St. Franziskus Hospitals Münster Objective: To evaluate the necessity of postoperative intervention one year after goniotrepanation with or without application of subconjunctival Triamcinolone in depending on IOD.
Methods: Retrospective clinical trial including 74 eyes (71 patients) with uncomplicated open angle glaucoma or PEX-glaucoma without previous surgery or additional eye diseases. The eyes were randomized to receive either 0.2 ml (= 8 mg) highly purified Triamcinolone acetonide (Triam-group, 35 eyes) or balanced salt solution (control group, 39 eyes) subconjunctivaly during surgery adjacent to the area of the scleral flap. One year after surgery the number of topical glaucoma medications, the postoperative intervention rate and complications were analyzed. In addition surgical outcome was evaluated by the postoperative IOP measures.
Results: After a mean follow-up of 53.2 weeks the mean IOP was reduced from 22.9 mmHg pre- to 13.0 mmHg postoperatively in the Triam-group, from 24.7 mmHg pre- to 13.8 mmHg in the control group. For 10 eyes of the Triam group and 13 eyes in the control-group additional antiglaucoma medications were necessary to reach target IOP. In the Triam-group 23 needling in 6 eyes and 2 revision surgeries in 2 eyes were needed whereas in the control group needling was performed 18 times in 10 eyes and revision surgery 1 time in 1 eye. None of the eyes had an IOP more than 20 mmHg. Regarding the postoperative results and necessity of postoperative interventions there are no significant differences between these two groups.
Conclusions: Subconjunctival Triamcinolone during filtering surgery showed the same satisfying outcome as goniotrepanation alone in cases of uncomplicated open angle glaucoma. There are no significant different numbers of postoperative interventions between these examined groups. Finally it makes sense to verify these results in a study with more eyes and for any length of time.
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