Fornix-based versus limbal-based conjunctival flaps in trabeculectomy with mitomycin C in high-risk patients

Utako Kuroda, Toshihiro Inoue, Nanako Awai-Kasaoka, Kohei Shobayashi, Sachi Kojima, Hidenobu Tanihara

Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

Purpose: To compare the surgical outcomes of limbal-based and fornix-based trabeculectomy in eyes with a history of ocular incisional surgery.
Methods: Twenty-six eyes underwent limbal-based trabeculectomy (group LB), and were condition matched with 26 eyes that received fornix-based trabeculectomy (group FB). Surgical failure was recorded retrospectively if the intraocular pressure value was either ≥21, ≥18, and ≥15 mmHg (conditions A, B, and C, respectively) or <4 mmHg or if the patient required additional glaucoma surgery. Kaplan–Meier survival curve analysis was used to assess surgical failure.
Results: For condition A, the 2 year surgical success probabilities were 75.0% and 63.9% in groups FB and LB, respectively (P=0.124). The corresponding values were 55.0% and 61.7% (P=0.638) in condition B, and 55.0% and 57.0% (P=0.454) in condition C. The rates of bleb leakage, hypotony, choroidal detachment, and bleb-related infection were 11.5%, 26.9%, 50.0%, and 7.7% in group LB, respectively. The corresponding values in group FB were 30.8%, 23.1%, 46.2%, and 0.0%, which were not statistically different between the two groups.
Conclusion: No significant differences in surgical outcomes were observed between limbal-based and fornix-based trabeculectomy for patients with a history of incisional ocular surgeries.

Keywords: trabeculectomy, previous surgery, surgical outcomes, surgical complications