Original articleRisk of Endophthalmitis and Other Long-Term Complications of Trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS)
Section snippets
Methods
The CIGTS was approved by the University of Michigan Institutional Review Board as well as by the institutional review board at each of the 14 clinical centers. The detailed methodology of the CIGTS has been described previously.9, 20 Briefly, the CIGTS involved 36 surgeons at 14 clinical centers and was approved by the institutional review boards at each site; written informed consent was obtained from all participants. The study enrolled 607 patients with newly diagnosed open-angle glaucoma
Patients
Three hundred of the 607 CIGTS patients were randomized to intervention with trabeculectomy. After randomization, 10 patients changed their minds and chose not to undergo initial trabeculectomy. Eight of these patients underwent ALT as the first intervention, whereas 2 patients opted for medications. Four patients had no follow-up either because of death or drop-out before or shortly after treatment, whereas 1 patient had only 9 months of follow-up after a several-year delay in undergoing
Discussion
For surgical approaches to treating open-angle glaucoma with the potential for infectious complications, an adequate assessment of risks and benefits is critical. There is a theoretically reduced risk of infection in nonpenetrating glaucoma surgery, given the lack of complete ocular penetration when compared with conventional trabeculectomy. Reported infectious complications in nonpenetrating glaucoma surgery have been limited to isolated reports of fungal and bacterial keratitis and blebitis.21
Sarwar Zahid is a fourth year medical student at the University of Michigan Medical School, Ann Arbor, Michigan. Given his immense interest in ophthalmology, he pursued a one-year research fellowship with the retinal dystrophy team at the Kellogg Eye Center, Ann Arbor, Michigan. His long-term career goal is to further build on his research training in order to become an excellent clinical and academic ophthalmologist.
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Sarwar Zahid is a fourth year medical student at the University of Michigan Medical School, Ann Arbor, Michigan. Given his immense interest in ophthalmology, he pursued a one-year research fellowship with the retinal dystrophy team at the Kellogg Eye Center, Ann Arbor, Michigan. His long-term career goal is to further build on his research training in order to become an excellent clinical and academic ophthalmologist.