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Title	Glaucoma surgery outcome in Rwanda
Abstract Nr.	1048

Purpose	To assess long term intraocular pressure (IOP) outcome after adult trabeculectomy surgery in Africa.
Methods	All adult glaucoma patients who underwent trabeculectomy surgery in the Kabgayi Eye Unit, Rwanda between August 2003 and March 2008 were invited for a follow-up visit. Surgical and clinical data were collected from medical records. At the study visit best corrected visual acuity was measured and Goldmann applanation tonometry and biomicroscopy done. Good IOP outcome was defined as both an intraocular pressure ≤ 15mmHg and achieving ≥ 30% reduction from the preoperative IOP. Odds ratios for good IOP outcome were calculated for potential predictors.
Results	Participation rate was 74.2% (118 patients, 161 eyes). Preoperatively, the mean IOP was 31.2mmHg (SD 10.7, range 12-60). Anti-metabolites were applied during the operation in 79.5% of eyes. At the time of the follow-up study visit the mean postoperative IOP was 13.0 mmHg (SD= 5.1, range 4-35). The mean follow-up after the operation was 27.43 months (SD= 14.67, range 7- 83). A good IOP outcome was achieved in 66.9% (n=105) of eyes. The use of mitomycine C during trabeculectomy (OR=3.0, CI= 1.2-7.1, P=0.008), long duration of follow-up (OR= 0.31, CI= 0.11- 0.7, P= 0.009) and the presence of an elevated bleb (OR= 3.2, CI= 1.3- 8.1, P= 0.012) were significant predictors.
Conclusion	Trabeculectomy with mitomycine C is effective in lowering IOP in Central Africa. However, the IOP control reduced over time, highlighting the importance of regular long-term follow-up in this part of the world.

Authors 1

Last name	DE SMEDT
Initials	S
Department	Kabgayi Eye Unit
City	Rwanda

Authors 2

Last name	Fonteyne
Initials	Y
Department	Kabgayi Eye Unit
City	Rwanda