Ophthalmology
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Item Outcome of combined trabeculotomy-trabeculectomy in eyes of Nigerian children with primary congenital glaucoma(West African College of Physicians and the West African College of Surgeons, 2023-08) Ugalahi, M. O.; Adeyemo, A. O.; Olusanya, B. A.; Baiyeroju, A. M.PURPOSE: To report the outcome of combined trabeculectomy among children with primary congenital glaucoma at a child eye health tertiary facility in southwest Nigeria. METHODS: A retrospective review of children who underwent combined trabeculotomy-trabeculectomy (CTT) surgery on account of primary congenital glaucoma between 2016 and 2020 at the University College Hospital, Ibadan, Nigeria. All surgeries were performed by paediatric ophthalmologists. The main outcome measures were postoperative intraocular pressure, corneal clarity, and complications. RESULTS: A total of 21 eyes of 13 patients were included. Ten (76.9%) of the patients were males and 8 (61.5%) had bilateral disease. The mean age at presentation was 4.8 (± 3.6) months, while the mean age at surgery was 8.1 (± 5.9) months. The average waiting time between noticing symptoms and presenting to the clinic was 3.2 (±4.9) months. The mean horizontal corneal diameter was 13.2 (± 1.4) mm, while the mean pre-operative intraocular pressure (IOP) was 25.7 (± 8.6) mmHg. The surgical success (IOP<21 mmHg) rates at 3, 6, and 12 months were 86.7%, 64.3%, and 92.9% respectively. The Kaplan-Meier estimates of the probability that IOP remained below 21 mmHg up till 3, 6, and 12 months were 74%, 53%, and 53% respectively. Postoperatively, 85.7% of the eyes had complete resolution of corneal oedema. One eye had an intraoperative complication of vitreous loss. The post-operative clinic follow-up rate reduced to 52.4% by 1 year. CONCLUSION: Combined trabeculotomy-trabeculectomy is a relatively safe procedure that is associated with favorable success in Nigerian children with primary congenital glaucoma.Item Outcome of trabeculectomy with 5-fluorouracil using releasable suture technique in a Nigerian tertiary hospital(West African College of Physicians (WACP) and the West African College of Surgeons (WACS), 2011-06) Komolafe, O. O.; Ashaye, A. O.; Bekibele, C. O.; Baiyeroju, A. M.; Olawoye, O. O.BACKGROUND: Trabeculectomy has undergone a series of modifications in recent times most of which are aimed at improving the efficacy of the procedure while reducing complications. The use of releasable sutures is one of such modifications. OBJECTIVE: To assess the efficacy and complications associated with the use of releasable sutures and 5- Fluorouracil(5-FU) in trabeculectomy among indigenous African patients with primary open angle glaucoma. METHODS: This was a chart review of 22 eyes of 17 patients diagnosed with primary open angle glaucoma. All the eyes included in the review had trabeculectomy with 5-Fluorouracil using releasable suture technique with postoperative clinic follow- up visit for a minimum period of 72 weeks. Information sought included patient’s demographics, preoperative antiglaucoma medications, pre- and post- operative intraocular pressure, and associated complications. RESULTS: There were 17(13 M, 4 F) patients with 22 eye surgeries. Their mean age was 49.8 ± 9.3 years. The mean preoperative intraocular pressure was 27.7 ± 5.9 mmHg. The intraocular pressure on the first post-operative day was 10.6 ± 11.1 mmHg. The mean pressure before the removal of the releasable suture was 14.1 ± 10.8 mmHg and after removal was 6.0 ± 7.2 mmHg, (p < 0.0001). The mean intraocular pressure at 72 weeks of follow up was 16.9 ± 5.6 mmHg. A qualified success rate of 81.8% was achieved in terms of intraocular pressure control. There were two eyes complicated by blebitis and an eye complicated by malignant glaucoma. CONCLUSION: The use of releasable suture in trabeculectomy helped in maintaining the intraocular pressure at a lower level in the early postoperative period and in reducing postoperative shallowing of the anterior chamber. The procedure appears to be associated with some sight- threatening complications such as endophthalmitis.