Trabeculectomy Outcomes and Predictive Factors for Surgical Failure in Glaucoma Patients at a Tertiary Hospital, Northern Tanzania

Abstract

Aim: To evaluate long term outcomes of trabeculectomy and associated factors for failure among adult glaucoma patients in northern Tanzania from January 2013 to December 2023. Study Design: This was a hospital based retrospective cohort study. Place and Duration of Study: Department of Ophthalmology, Kilimanjaro Christian Medical Center, Northern Tanzania, between January 2013 and December 2023. Methodology: This study included 286 eyes from 247 adult glaucoma patients aged ≥18 years who underwent primary trabeculectomy (TE), with or without cataract surgery. Data were consecutively extracted from medical records. Surgical success was defined as postoperative intraocular pressure (IOP) between 6 and 21 mmHg. Data were analyzed using STATA 17. Results: The median (IQR) age at surgery was 63 years (range, 53–71). Mean (±SD) follow up time was 11 (±1.4) months. The surgical success rate was 84.2% at 12 months. The median (IQR) IOP was reduced from 30 (17-58) mmHg at baseline to 12 (7-31) mmHg, (P < 0.001) at 12-months post operatively. High baseline IOP (Hazard ratio = 1.72, P = 0.037) and older age at operation (Hazard ratio = 2.22, P = 0.008) were the only significant risk factors associated with a higher likelihood of trabeculectomy failure. Conclusion: Trabeculectomy has shown higher success rates within 12-months among adult glaucoma patients in northern Tanzania. Achieving favorable outcomes in lowering IOP and reducing the number of medications.