JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE

Table of Contents

2019 Month : October Volume : 6 Issue : 43 Page : 2809-2813

Outcomes Following Trabeculectomy Done by Conventional Method and Kelly’s Punch in Primary Open Angle Glaucoma: A Comparative Study

Ratandeep Kumar Agrawalla1, Soumen Chakraborty2

Corresponding Author:
Dr. Soumen Chakraborty,
#D277, Luna Street,
Durgapur- 713212,
West Bengal.
E-mail: schak277@gmail.com
DOI: 10.18410/jebmh/2019/583

abstract
BACKGROUND
Over the years, the practice of doing trabeculectomy with a Kelly’s Descemet membrane punch has become increasingly common. But literature describing its comparison to traditional trabeculectomy is few and far between. This study was therefore conducted to evaluate and compare the surgical outcomes and complications of trabeculectomy done conventionally and that done by Kelly’s punch in patients with primary open angle glaucoma.

METHODS
Patients diagnosed as primary open angle glaucoma (POAG) having bilateral involvement and unresponsive to maximal medical therapy were enrolled in this study. Sixty-eight such patients seen in a 4-year 7-month period underwent conventional trabeculectomy in one eye (Group 1) and trabeculectomy with a Kelly’s Descemet membrane punch in the other eye (Group 2). Both the groups were evaluated in terms of mean IOP reduction, sustainability for a period of next six months and post-operative complications.

RESULTS
The mean IOP reduction in Group 1 was 12 mmHg and in Group 2 was 9 mmHg from the pre-operative mean at the end of the six post-operative weeks. Sustainability at the end of six months was attained in 88% of eyes in Group 1 and in 85% of eyes in Group 2. Overall incidence of early post-operative complications was less in Group 2. The incidence of cataract formation was 13% in Group 1 and 8% in Group 2 and during the same period of time. More serious sight threatening complications like persistent hypotony, bleb infection and endophthalmitis were not encountered in either group.

CONCLUSIONS
Both the techniques offer adequate and sustainable post-operative IOP control. Early postoperative complications are however marginally higher in the conventional group.

KEYWORDS
Trabeculectomy, Conventional, Kelly’s Punch, Intra Ocular Pressure (IOP)