Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study [version 1; referees: 2 approved]
Background: Pilocarpine is commonly used after angle surgery for glaucoma despite a host of side effects and risks. We hypothesized that a pharmacological miosis during the first two months does not improve short- and long-term results of trabectome-mediated ab interno trabeculectomy. Methods: In th...
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doaj-203f2b0b8bb24e4782b517b44305dead2020-11-25T03:12:36ZengF1000 Research LtdF1000Research2046-14022018-02-01710.12688/f1000research.13756.114948Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study [version 1; referees: 2 approved]Hamed Esfandiari0Kiana Hassanpour1Mehdi Yaseri2Nils A. Loewen3Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USAOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranDepartment of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USABackground: Pilocarpine is commonly used after angle surgery for glaucoma despite a host of side effects and risks. We hypothesized that a pharmacological miosis during the first two months does not improve short- and long-term results of trabectome-mediated ab interno trabeculectomy. Methods: In this retrospective comparative 1-year case series, we compared 187 trabectome surgery eyes with (P+) or without (P-) 1% pilocarpine for two months. Primary outcome measures were the surgical success defined as intraocular pressure (IOP) ≤ 21 mmHg and decreased ≥ 20%, and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, and IOP. Results: We categorized 86 (46%) eyes as P- and 101 (54%) eyes as P+. The mean age was 69.8±10.1 in P- and 70.5±9.4 in P+ (P=0.617) with equal gender distribution (P=0.38). The cumulative probability of qualified success at 12 months was 78.1% in the P- and 81% in the P+ (P=0.35). The IOP was decreased significantly from 20.2±6.8 mmHg at baseline to 15.0±4.8 mmHg at 12 months follow-up in P- (P=0.001) and 18.8±5.3 and 14.7±4.0, respectively (P=0.001). The medications decreased significantly from 1.4±1.2 in P- and 1.4±1.2 in P+ at baseline to 1.0±1.2 and 0.7±1.0, respectively (P=0.183). P- and P+ did not differ in IOP or medications (all P>0.05). In Multivariate Cox Regression models, the baseline IOP and central corneal thickness were associated with failure. Conclusions: Use of postoperative pilocarpine does not improve the efficacy of trabectome surgery.https://f1000research.com/articles/7-178/v1 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hamed Esfandiari Kiana Hassanpour Mehdi Yaseri Nils A. Loewen |
spellingShingle |
Hamed Esfandiari Kiana Hassanpour Mehdi Yaseri Nils A. Loewen Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study [version 1; referees: 2 approved] F1000Research |
author_facet |
Hamed Esfandiari Kiana Hassanpour Mehdi Yaseri Nils A. Loewen |
author_sort |
Hamed Esfandiari |
title |
Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study [version 1; referees: 2 approved] |
title_short |
Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study [version 1; referees: 2 approved] |
title_full |
Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study [version 1; referees: 2 approved] |
title_fullStr |
Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study [version 1; referees: 2 approved] |
title_full_unstemmed |
Extended pharmacological miosis is superfluous after glaucoma angle surgery: A retrospective study [version 1; referees: 2 approved] |
title_sort |
extended pharmacological miosis is superfluous after glaucoma angle surgery: a retrospective study [version 1; referees: 2 approved] |
publisher |
F1000 Research Ltd |
series |
F1000Research |
issn |
2046-1402 |
publishDate |
2018-02-01 |
description |
Background: Pilocarpine is commonly used after angle surgery for glaucoma despite a host of side effects and risks. We hypothesized that a pharmacological miosis during the first two months does not improve short- and long-term results of trabectome-mediated ab interno trabeculectomy. Methods: In this retrospective comparative 1-year case series, we compared 187 trabectome surgery eyes with (P+) or without (P-) 1% pilocarpine for two months. Primary outcome measures were the surgical success defined as intraocular pressure (IOP) ≤ 21 mmHg and decreased ≥ 20%, and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, and IOP. Results: We categorized 86 (46%) eyes as P- and 101 (54%) eyes as P+. The mean age was 69.8±10.1 in P- and 70.5±9.4 in P+ (P=0.617) with equal gender distribution (P=0.38). The cumulative probability of qualified success at 12 months was 78.1% in the P- and 81% in the P+ (P=0.35). The IOP was decreased significantly from 20.2±6.8 mmHg at baseline to 15.0±4.8 mmHg at 12 months follow-up in P- (P=0.001) and 18.8±5.3 and 14.7±4.0, respectively (P=0.001). The medications decreased significantly from 1.4±1.2 in P- and 1.4±1.2 in P+ at baseline to 1.0±1.2 and 0.7±1.0, respectively (P=0.183). P- and P+ did not differ in IOP or medications (all P>0.05). In Multivariate Cox Regression models, the baseline IOP and central corneal thickness were associated with failure. Conclusions: Use of postoperative pilocarpine does not improve the efficacy of trabectome surgery. |
url |
https://f1000research.com/articles/7-178/v1 |
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