Bilateral simultaneous trabeculectomy. A review of outcome and a survey of ophthalmologists' attitudes

Abstract

In this study the attitudes of experienced ophthalmologists to bilateral simultaneous trabeculectomy were canvased using a postal questionnaire. Only 16% of respondents ever performed bilateral simultaneous trabeculectomy (BST). The main reason for not performing BST was fear of bilateral simultaneous complications. The notes of 95 patients who had undergone BST were reviewed. Post-operative complications occurred in 41 eyes (43.6%) during the first post-operative week, but only 8 patients (8.5%) hand complications in both eyes. At 3 months post-operatively, 5 patients (5.5%) had bilateral raised intraocular pressures with or without medication, and at 12 months this figure was 8 patients (9.3%). Twenty patients (21.3%) had a drop in visual acuity of two Snellen lines or more in both eyes at one week. At 3 months this figure was 5 patients (5.5%), and at 12 months 3 patients (3.5%) had lost two or more lines of vision in both eyes. Although BST is not commonly performed, the incidence of bilateral post-operative complications is low.