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Surgical outcomes of phakic, pseudophakic and combined phaco-trabeculectomy in a tertiary care centre in Saudi Arabia

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Abstract

Purpose

To compare the outcomes of phakic, pseudophakic and combined phaco-trabeculectomy in eyes of Saudi patients.

Methods

This was a retrospective cohort study. Eyes of patients with primary open angle glaucoma, primary angle closure glaucoma or secondary exfoliation glaucoma (XFG) that underwent phakic (n = 152), pseudophakic (n = 40) or combined phaco-trabeculectomy (n = 45) at the King Khaled Eye Specialist Hospital, Riyadh from January 2012 to December 2017 were included. The primary outcome measure was the success at 3 years after surgery. Complete success was defined as achieving an intraocular pressure (IOP) of ≥ 6 and ≤ 21 mmHg without topical antiglaucoma medications; qualified success as achieving the same IOP criteria with or without the use of glaucoma medications. Cumulative probabilities of failure were computed using Kaplan–Meier survival analysis. We used Cox regression analysis to identify factors associated with treatment failure. Reduction in mean IOP and AGM over time was estimated using mixed-effects linear models.

Results

The mean decrease in IOP at 3 years from baseline in the phakic, pseudophakic and combined groups was 12.0 (95% CI, 9.9, 14.1) mmHg, 10.1 (95% 6.3, 13.9) mmHg, and 6.4 (95% CI, 1.9, 11.0) mmHg, respectively, and was not significantly different from each other. The values for qualified success were also comparable: 95.2% (95% CI: 86.7–99.0), 95.3% (95% CI: 76.2–99.9), 92.3% (95% CI: 64.0–99.8). Failure was significantly associated with postoperative suturelysis (p = 0.004), XFG (p = 0.018) and AGM (p = 0.038).

Conclusions

This is the first study to provide relative surgical outcomes of trabeculectomy, phaco-trabeculectomy and pseudophakic trabeculectomy in Saudi Arabia and did not show any significant difference in terms of overall success.

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Availability of data and material

The data can be made available subject to IRB permission at irb@kkesh.med.sa.

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Acknowledgements

We acknowledge the contribution of Mr. Sami Alghamdi, Research co-ordinator, King Khaled Eye Specialist Hospital, for assistance with data entry and verification.

Funding

There were no sources of funding for this study.

Author information

Authors and Affiliations

  1. Glaucoma Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

    Mohammed Dibaji, Fahad Alghulaydhawi, Norah Fahad, Mozon AlShareef, Sami AlShahwan, Ali AlBeshri & Rizwan Malik

  2. Prince Sattam Bin Abdulaziz University, Riyadh, Saudi Arabia

    Fahad Alghulaydhawi

  3. Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

    Khabir Ahmad & Rajiv Khandekar

  4. Department of Ophthalmology and Visual Science, University of Alberta, Edmonton, AB, Canada

    Rizwan Malik

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  1. Mohammed Dibaji
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  2. Fahad Alghulaydhawi
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Correspondence to Rizwan Malik.

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Dibaji, M., Alghulaydhawi, F., Fahad, N. et al. Surgical outcomes of phakic, pseudophakic and combined phaco-trabeculectomy in a tertiary care centre in Saudi Arabia. Int Ophthalmol 42, 2903–2914 (2022). https://doi.org/10.1007/s10792-022-02280-y

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