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TitrePreoperative non-steroidal anti-inflammatory drug or steroid and outcomes after trabeculectomy. A randomized controlled trial
Abstract Nr.323
ButTo investigate a preoperative treatment with either topical non-steroidal
anti-inflammatory drug (NSAID) or steroid in terms of outcomes following trabeculectomy.
MéthodesBetween 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.
RésultatsFifty-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).
ConclusionTopical 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.
Auteur 1
NomBREUSEGEM
InitialesC
VilleLEUVEN
Auteur 2
NomSPIELBERG
InitialesL
VilleLEUVEN
Auteur 3
NomVAN GINDERDEUREN
InitialesR
VilleLEUVEN
Auteur 4
NomVANDEWALLE
InitialesE
VilleLEUVEN
Auteur 5
NomRENIER
InitialesC
VilleLEUVEN
Auteur 6
NomVANDEVEIRE
InitialesS
VilleLEUVEN
Auteur 7
NomFIEUWS
InitialesS
VilleLEUVEN
Auteur 8
NomZEYEN
InitialesT
VilleLEUVEN
Auteur 9
NomSTALMANS
InitialesI
InstitutUZ LEUVEN
VilleLEUVEN
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