The advanced glaucoma intervention study (AGIS): 5. encapsulated bleb after initial trabeculectomy - 08/09/11
the Agis Investigators
Abstract |
PURPOSE: To compare the incidence of encapsulated bleb after trabeculectomy in eyes with and without previous argon laser trabeculoplasty and to assess other risk factors for encapsulated bleb development.
METHODS: After medical treatment failure, eyes enrolled in the Advanced Glaucoma Intervention Study (AGIS) were randomly assigned to sequences of interventions starting with either argon laser trabeculoplasty or trabeculectomy. In the present study we compared the clinical course for 1 year after trabeculectomy in 119 eyes with failed argon laser trabeculoplasty with that of 379 eyes without previous argon laser trabeculoplasty. Data on bleb encapsulation were collected at the time that the encapsulation was diagnosed, and 3 and 6 months later.
RESULTS: Of multiple factors examined in the AGIS data for the risk of developing encapsulated bleb, only male gender and high school graduation without further formal education were statistically significant. Encapsulation occurred in 18.5% of eyes with previous argon laser trabeculoplasty failure and 14.5% of eyes without previous argon laser trabeculoplasty (unadjusted relative risk, 1.27; 95% confidence limits = 0.81, 2.00; P = .23). After adjusting for age, gender, educational achievement, prescribed systemic β-blockers, diabetes, visual field score, and years since glaucoma diagnosis, this difference remains statistically not significant. Four weeks after trabeculectomy, mean intraocular pressure was 7.5 mm Hg higher in eyes with (22.5 mm Hg) than without (15.0 mm Hg) encapsulated bleb; at 1 year after trabeculectomy and the resumption of medical therapy when needed, this excess was reduced to 1.4 mm Hg.
CONCLUSIONS: This study, as did two previous studies, found male gender to be a risk factor for bleb encapsulation. Four studies, including the present study, have reported a higher rate of encapsulation in eyes with previous argon laser trabeculoplasty; in two of the studies, one of which was the present study, the rate was not statistically significantly higher; in the other two studies the rate was significantly higher. The 4-week postoperative mean intraocular pressure was higher in eyes with than without encapsulated bleb; with the resumption of medical treatment the two means converged after 1 year.
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 | Supported by grants from the National Eye Institute, National Institutes of Health and U.S. Department of Health and Human Services (grant nos. 2 U10 EY06824 through 2 U10 EYO6827,2 U10 EY06830 through 2 U10 EY06835, 2 U10 EY07057, and 7 U10EY09640). |
Vol 127 - N° 1
P. 8-19 - janvier 1999 Retour au numéro
Article précédent
- Comparison of corneal wavefront aberrations after photorefractive keratectomy and laser in situ keratomileusis
- Tetsuro Oshika, Stephen D Klyce, Raymond A Applegate, Howard C Howland, M.Alaa El Danasoury
- Brimonidine tartrate 0.2% twice daily vs timolol 0.5% twice daily: 1-year results in glaucoma patients
- L.Jay Katz, the Brimonidine Study Group∗The Brimonidine Study Group members are listed at the end of the article. ∗
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