Evaluation of early ocular discomfort after glaucoma surgery: trabeculectomy versus Ahmed glaucoma valve implantation

• Published in: Arquivos brasileiros de oftalmologia Vol. 87; no. 3; p. e20230033
• Main Authors: Abe, Ricardo Y, Yamamoto, Douglas R, Souto, Fernanda Maria Silveira, Vasconcellos, José Paulo Cabral, Costa, Vital Paulino
• Format: Journal Article
• Language: English
• Published: Brazil Conselho Brasileiro de Oftalmologia 2024
• Subjects: Foreign Bodies - complications; Foreign Bodies - surgery; Glaucoma - etiology; Glaucoma Drainage Implants - adverse effects; Humans; Intraocular Pressure; OPHTHALMOLOGY; Prospective Studies; Prosthesis Implantation - adverse effects; Retrospective Studies; Trabeculectomy - adverse effects; Treatment Outcome; Trabeculectomy; Paresthesia; Glaucoma/surgery; Postoperative care; Glaucoma drainage implants
• ISSN: 0004-2749; 1678-2925; 1678-2925
• DOI: 10.5935/0004-2749.2023-0033

This study aims to compare the initial ocular discomfort symptoms resulting from trabeculectomy and Ahmed glaucoma valve implantation surgeries. A prospective comparative study was conducted. The evaluation of ocular discomfort employed a questionnaire designed to identify the frequency and severity of distinct symptoms: ocular pain, general discomfort, tearing, foreign body sensation, and burning. This questionnaire was administered prior to surgery as a baseline, and subsequently at 7, 30, and 90 days post-surgery. Simultaneously, the Ocular Surface Disease Index (OSDI) was applied at these same time intervals. The study encompassed a total of 17 patients (9 undergoing trabeculectomy and 8 undergoing Ahmed glaucoma valve implantation). The Ahmed glaucoma valve implantation group exhibited higher tearing levels at baseline (p=0.038). However, no statistically significant differences in symptoms were observed between the two surgeries at 7 and 30 days post-surgery. At the 90-day mark following surgery, patients who had undergone trabeculectomy reported a significantly higher foreign body sensation (p=0.004). Although OSDI scores did not differ between groups at baseline, the trabeculectomy group showed significantly higher OSDI scores than the Ahmed glaucoma valve implantation group at 7, 30, and 90 days after surgery (p<0.05). Post-surgery, patients who had undergone trabeculectomy experienced increased foreign body sensation. Trabeculectomy appears to cause greater early postoperative ocular discomfort compared to the Ahmed glaucoma valve implantation group.