The Advanced Glaucoma Intervention Study, 8: Risk of cataract formation after trabeculectomy

Authors
Blackwell, B Ederer, F Van Veldhuisen, PC Sullivan, EK Dally, LG Weber, PA Miller, E Katz, LJ Ashburn, F Beck, A Costarides, A Leef, D Closek, J Banks, J Jackson, S Moore, K Vela, A Brown, RH Lynch, M Gunsby, J Lober, K Marsh, T Stepka, C Montgomery, R Clagett, D Ashburn, F Schacht, K Coyle, E Garland, MK Lauber, S Michelitsch, K Plavnieks, S Vayer, L Burt, E Hundley, M Rae, A Allen, RC Miller, E Sporn, A Fendley, CK Hoyle, LS Weber, PA McKinney, K Moore, D Lauderbaugh, T Baker, ND Kapetansky, F Lehmann, D Black, L Derick, R Gloeckner, B Coleman, K Cassady, M Sharf, LJ Romans, B Satterwhite, Y Simmons, L Vela, MA Harbin, TS Brannon, L LaSalle, J Degenhardt, G Bridgman, SA Ozment, RR Gunsby, J Hooper, M Wright, J Goldstein, S Butler, L Perry, M Eckel, A Martin, A Nummerdor, D Wille, L Cyrlin, MN Dubay, H Fazio, R Corbin, PS Wilensky, JT Lindenmuth, K Hillman, D Carroll, CA Hatton, J Sonty, S Carroll, CA Higginbotham, EJ Scholes, G Uva, R Fiene, J Frohlichstein, D Gates, V Pappas, L Rathbone, D Tadelman, M Hopkins, G Lichter, PR Bergstrom, TJ Moroi, SE Pollack-Rundle, CJ Standardi, C Abt, L Van Heck, T Skuta, GL Higginbotham, EJ Schertzer, RM Wicker, D Michael, B Aaron, D Birk, J Brown, RS Dederian, J Kruscke, L Ziehm-Scott, J Papierniak-Dubiel, R Prum, BE Newman, SA Powell, L Evans, C Barbour, N Shoffstall-Tyler, L Voight, T Nordlund, JR Schott, LJ Fornili, R Chisholm, J Harrell, C Harris, C Murphy, E Schwartz, AL Weiss, H Boeckl, A Tillman, C Boeckl, A Maloney, L Cirone, M Gurley, J Morris, M O'Dea, M Pappas, S Wehrly, S Reed, C Witol, CV Browning, J Carmody, K Driskell, T Harris, E Lopez, P Mercer, R Monks, V Vawter, K Zhao, J Katz, LJ Spaeth, GL Wilson, RP Myers, J Samuel, F Meli, A Kao, S Terebuh, A Beckershoff, CC Shields, MB Shafranov, G Leone, A Grottole, G Miller, E Caprioli, J Tressler, C Roche-Manna, M VanVeldhuisen, PC Ederer, F Dally, LG Blackwell, B Inman, P Raitt, S Lindblad, AS Knoke, JD Sullivan, EK Wu, LL Entler, G Phillips, P Smith, C Bradford, M Denekas, M Wagner, EL Stine, E Tomlin, KL Voss, T Furberg, CD Connett, JE Davis, MD Dueker, DK Green, SB Palmberg, PF Ederer, F Gaasterland, DE Cotch, MF Leikin, S Schneiderman, M Hamilton, MP Mowery, RL VanVeldhuisen, PC Schwartz, AL Lindblad, AS Knoke, JD Sullivan, EK Schwartz, AL Kassoff, A Cotch, MF Cyrlin, MN Vela, MA Caprioli, J Higginbotham, EJ Skuta, GL Katz, LJ Weber, PA Allen, RC Wilensky, JT Miller, E Brown, R Prum, B Cyrlin, M Beck, A Lichter, P Leef, D McKinney, K Reed, C Uva, R Samuel, F Roche-Manna, M Standardi, C Coyle, E Boeckl, A Pollack-Rundle, CJ Carroll, CA Sporn, A Leone, A Mowery, RL Kassoff, A Katz, LJ Leef, D Skuta, GL Samuel, F Lindblad, AS Reed, C Beckershoff, CC Entler, G Wagner, EL
Citation
B. Blackwell et al., The Advanced Glaucoma Intervention Study, 8: Risk of cataract formation after trabeculectomy, ARCH OPHTH, 119(12), 2001, pp. 1771-1780
Citations number
29
Categorie Soggetti
Optalmology,"da verificare
Journal title
ARCHIVES OF OPHTHALMOLOGY
ISSN journal
00039950 → ACNP
Volume
119
Issue
12
Year of publication
2001
Pages
1771 - 1780
Database
ISI
SICI code
0003-9950(200112)119:12<1771:TAGIS8>2.0.ZU;2-Z
Abstract
Objectives: To compare the risk of cataract formation in eyes with and with out prior trabeculectomy and to assess other risk factors for cataract. Methods: The Advanced Glaucoma Intervention Study (AGIS) has been following 789 eyes in 591 patients with medically uncontrolled open-angle glaucoma. From 1988 to 1992, these eyes were randomly assigned to either an argon las er trabeculoplasty (ALT)-trabeculectomy-trabeculectomy treatment sequence o r a trabeculectomy-ALT-trabeculectomy sequence. Cox regression analyses wer e used to assess risk factors for cataract formation during 7 to 11 years o f follow-up. Main Outcome Measures: Cataract, defined as either having had cataract surg ery or confirmed severe lens opacity with a best-corrected Early Treatment Diabetic Retinopathy Study visual acuity score less than 65 letters (worse than 20/50). Results: Data are presented on the expected 5-year cumulative probability o f cataract formation in each randomized sequence by age and presence of dia betes at study entry. Overall, approximately half of the eyes studied devel oped cataract. A first trabeculectomy, whether as the first or second AGIS intervention, increased the overall risk of cataract by 78% (risk ratio [RR ]=1.78; P < .001). Diabetes (RR=1.47; P=.004) and age at study entry (RR=1. 07 per year of age; P < .001) were also risk factors for cataract. When pos toperative complications of trabeculectomy were included in the analysis, t he increased risk of cataract for eyes with a first trabeculectomy reduced to 47% when complications did not occur (RR=1.47; P=.003) and increased to 104% when complications did occur (RR=2.04; P < .001). Several specific pos toperative complications of trabeculectomy were associated with increased r isk of cataract, particularly marked inflammation (RR=3.29; P < .001) and f lat anterior chamber (RR=1.80; P=.004). Trabeculectomy with complications w as also significantly associated with an increased risk of cataract in each of 3 lens regions: nuclear, cortical, and posterior subcapsular. Conclusions: In eyes of AGIS patients, after adjustment for age and diabete s, trabeculectomy increased the risk of cataract formation by 78%.