Trabeculectomy without antimetabolite in black African primary open angle glaucoma

Purpose: To assess simple trabeculectomy in black Africans with open angle glaucoma. Methods: We studied retrospectively 80 eyes of 62 patients with primary ope n angle glaucoma operated by Cairn's trabeculectomy without adjunction of a ntimetablites. Thirty seven eyes had a limbal-based conjonctival flap and t he others 43 had a fornix-based conjonctival flap. Failures and succes were assessed with the Kaplan-Meier's method. Results: Patients were ail seen at least 12 months after surgery. The mean follow up was 24 months. At mid-term survey we found complications to be fr equent. Pathological blebs occured in 22.5% (18 cases). The survival probab ility grew shorter with time. Only 44% of patients were reviewed at 36 mont hs and 29% at 48 months. The succes rate (IOP less than 21 mmHg of all glau coma medications) varied according to the conjonctival flap. It was respect ively at 12 months, 24 months and 36 months: 97%, 70% and 54% with limbal-b ased flap, and 46%, 18% and 18% with fornix-base flap. The overall rate of tonometric failures was 33.75%. Failures were more often with fornix- based flap (85%). Generally they set in before one year of survey. This was so i n 91% of absolute failures and in 87% of relative failures. The failures ra te seems to increase with topical polytherapy given more than 12 months bef ore operation. Conclusions: Trabeculectomy with limbal-based conjonctival flap is at mid-t erm follow up successful in black Africans. However the following up diffic ulties in Africa makes it a too delicate assessment objective for long-term results of trabeculectomy.