Trabeculectomy outcomes among patients with Glaucoma at Jimma university medical center department of ophthalmology from 2020 to 2023 in Jimma, Ethiopia

Abstract

Glaucoma is the second most common cause of blindness and has been the burden of the health sector for the past few years with its vision- and life-related threats. The presentation can be different based on its stage, and the most common means of treatment is medical, though surgical treatment like trabeculectomy can also be the best alternative with different indications that lead to variable success rates. Objectives The purpose of the study is to present the outcome of trabeculectomy at Jimma University Medical Center and its intraoperative and postoperative complications. Method A hospital-based, retrospective analytic study was conducted among patients who had undergone trabeculectomy in 2020–2023. A structured questionnaire was used to collect data, which was coded and entered into epidata and then exported to SPSS version 27 for statistical analysis. A descriptive statistical analysis, cross tabulations, linear logistic regression, chi-square test, and Fisher exact test were performed. P < 0.05 is considered statistically significant. Result A total of 79 patients were studied, with a mean age of 54.2 years and a male-to-female ratio of nearly 4:1. In this study, 30 (38%) surgeries were done by glaucoma surgeons, 39 (49.4%) of them by general ophthalmologists, and 10 (12.7%) of them by residents. In all cases, MMC was used, and in 43 (54.4%) of cases, MMC was soaked in subconjunctiva space, and in 36 (45.6%) of cases, MMC was given a subconjunctiva injection. Preoperatively, the mean IOP was 30.72 ± 10.941 mmHg, and the mean postoperative IOP at least six months after surgery was reduced to 12.68 mmHg ± 5.360 mmHg, p = 0.001. The preoperative mean VA was 0.11 ± 0.165, and the mean VA postoperatively at six months was 0.103 ± 0.112, p = 0.048. Complete success was found to be 83.5%, qualified success was 3.8%, failure was seen in 11.4%, and hypotony in 1.3%. The overall success (both complete and qualified success) was 88.5% based on IOP.

Conclusion and Recommendation Based on the IOP level, the success rate of trabeculectomy after six months of the surgery was 87.3%, which is good. The mean preoperative VA was dropped by one line, and there was a significant improvement in IOP six months after surgery. To explore predictors for surgical failure and increase efficacy, it is better to assess a long-term multicenter prospective follow-up study regarding the outcome of trabeculectomy