Long term results of glaucoma surgery among participants in an East African population survey

Aim-To evaluate the long term results of glaucoma surgery among people in E ast Africa. Methods-Participant in a population based survey of eye disease prevalence were offered glaucoma surgery using standardised criteria. Either surgical iridectomy or trabeculectomy was carried out as indicated by a medical offi cer or by one of two ophthalmologists. Trabeculectomy methods included rele asable sutures and mitomycin C in the majority of eyes. Subjects were exami ned during the first week and 2 months after surgery. Nearly 3 years later, re-examination was carried out in those who were still resident in the reg ion. Results-Among 46 people who were offered iridectomy, trabeculectomy, or com bined cataract extraction/lens implant/trabeculectomy, 21 people underwent surgery (46%). Of the 21, 19 were reexamined at 3 years (90%), including 16 /18 eyes after trabeculectomy. Among these, intraocular pressure (IOP) decl ined from 29.9 (SD 9.4) mm Hg to 14.7 (5.9) mm Hg, with 16 of 18 eyes (89%) achieving a reduction > 25%. Hypotony maculopathy, late bleb leak, and lat e endophthalmitis were not detected. Visually significant cataract develope d in 5/15 re-examined eyes that underwent trabeculectomy alone (33%), possi bly associated with preexisting cataract and diagnosis of angle closure gla ucoma, but not with mitomycin C use. Conclusions-Nearly half of those with glaucoma among residents of rural Afr ican villages accepted the offer of surgical therapy. While technical succe ss was achieved at satisfactory levels, the development of cataract must be considered an important issue for application of glaucoma surgical therapy programmes.