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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