THE BELGIAN OPHTHALMIC ASSOCIATIONS
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This abstract is assigned to session OB Free papers: Glaucoma
| Title | Preoperative non-steroidal anti-inflammatory drug or steroid and outcomes after trabeculectomy. A randomized controlled trial |
| Abstract Nr. | 323 |
| Purpose | To investigate a preoperative treatment with either topical non-steroidal anti-inflammatory drug (NSAID) or steroid in terms of outcomes following trabeculectomy. |
| Methods | Between July 2005 and October 2007, sixty-one consecutive medically uncontrolled glaucoma patients scheduled for first-time trabeculectomy were randomized to one of 3 study topical medication groups: NSAID (ketorolac), steroid (fluorometholone) or placebo (artificial tears). Patients instilled one drop four times daily for one month before the procedure and were examined on day 1 and 2, at weeks 1, 2, and 4, and at months 3, 6, 12, 18 and 24 following trabeculectomy. |
| Results | Fifty-four patients (54 eyes) were entered for analysis. The mean baseline IOP was 21.0±6.0 mmHg. The mean follow-up was 23.6±4.0 months. The percentage of patients requiring needling within the first year was 41% in the placebo group, 6% in the NSAID group and 5% in the steroid group (P = 0.006). The percentage of patients requiring IOP-lowering medication to reach the target IOP at one year was 24% in the placebo group, 18% in the NSAID group and 0% in the steroid group (P = 0.054 overall; P = 0.038 for steroids versus others). Log-rank test showed a significant (P =0.019) difference in medication-free survival curves between the different groups. Patients in the steroid group needed significantly less medication over the total follow-up time (P =0.007). |
| Conclusion | Topical ketorolac or fluorometholone for one month preoperatively was associated with improved trabeculectomy outcomes in terms of likelihood of postoperative needling. In the steroid group, there was a significant reduced need for additional postoperative IOP-lowering medication. |
Author 1
| Last name | BREUSEGEM |
| Initials | C |
| City | LEUVEN |
Author 2
| Last name | SPIELBERG |
| Initials | L |
| City | LEUVEN |
Author 3
| Last name | VAN GINDERDEUREN |
| Initials | R |
| City | LEUVEN |
Author 4
| Last name | VANDEWALLE |
| Initials | E |
| City | LEUVEN |
Author 5
| Last name | RENIER |
| Initials | C |
| City | LEUVEN |
Author 6
| Last name | VANDEVEIRE |
| Initials | S |
| City | LEUVEN |
Author 7
| Last name | FIEUWS |
| Initials | S |
| City | LEUVEN |
Author 8
| Last name | ZEYEN |
| Initials | T |
| City | LEUVEN |
Author 9
| Last name | STALMANS |
| Initials | I |
| Department | UZ LEUVEN |
| City | LEUVEN |