Early Postoperative Complications of Trabeculectomy and Their Management: A Hospital Based Study

Purpose:  To study the early post operative complications of trabeculectomy, Phaco trabeculectomy and their management in a tertiary care center. Study Design:  Interventional case series. Place and Duration of Study:  Al-Ehsan Welfare Eye Hospital from 1st November 2020 to 30th January 2022. Methods:  One hundred and two patients who underwent glaucoma filtration surgery were selected through convenient sampling. The patients were followed up for 12 weeks and early post-operative complications, if any, were noted and managed. Results:  There were 58 (56.86%) males and 44 (43.14%) females. The age ranged from 35 to 70 years. There were 48 (47.06%) pseudophakic and 54 (52.94%) phakic patients. Mean pre-operative IOP was (31.99 ± 5.66 mm Hg) which reduced to 12.35 ± 4.30 mm Hg one month after surgery. Trabeculectomy with 5-Fluorouracil (5-FU) was performed in 48 patients (47.06%) while trabeculectomy combined with phacoemulsification and IOL implantation was performed in 54 patients (52.94%). Primary open angle glaucoma (POAG) was present in 94 patients (92.16%) while 8 patients (7.84%) had chronic angle closure glaucoma. The early postoperative complications were shallow anterior chamber in 17.6%, pupillary membrane in 2.9% and choroidal detachment in 2.9%. Six patients (5.9%) were steroid responder and these patients were shifted to topical Loteprednol from topical prednisolone. Conclusion:  Majority of early post operative complications of trabeculectomy are transient and settled in first two to three weeks without any surgical intervention. Anticipation, timely diagnosis and early intervention is the key to success in management of complications of trabeculectomy.