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Peer-reviewedCC BY-NC-ND 4.0Journal of Glaucoma

Preoperative Topical Steroid Use and Trabeculectomy Outcomes

  • Tasuku Sunami1,2
  • Akiko Narita1,2
  • Tomoe Miyake1
  • Momoka Miyake1
  • Etsuko Akimoto1
  • Jiro Seguchi1
  • Riku Akatsuka2
  • Yuki Morizane2
  1. 1Department of Ophthalmology, Okayama Saiseikai General Hospital, Okayama, Japan
  2. 2Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
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Abstract

Précis:: Preoperative topical steroid use was associated with greater surgical success and thicker, less reflective bleb walls on anterior segment optical coherence tomography 1 year after trabeculectomy.

Purpose:: To assess the associations of preoperative topical steroid administration with surgical outcomes and filtering bleb morphology 1 year after trabeculectomy.

Patients and Methods:: This study included 304 eyes from 272 patients who underwent primary trabeculectomy with mitomycin C. Eyes were classified into steroid and nonsteroid groups based on preoperative topical steroid administration for 7 days. The primary outcome was surgical success at 1 year, defined by either criterion A [intraocular pressure (IOP) ≤15 mm Hg and a ≥20% reduction from preoperative IOP] or criterion B (IOP ≤12 mm Hg and a ≥30% reduction from preoperative IOP), achieved without glaucoma medication or additional glaucoma surgery. Bleb morphology was evaluated using anterior segment optical coherence tomography (AS-OCT). Multivariable Cox regression was used to adjust for potential confounders.

Results:: At 1 year, surgical success rates were significantly higher in the steroid group than in the nonsteroid group for both criterion A (85.5% vs. 71.1%, P=0.005) and criterion B (76.4% vs. 65.4%, P=0.040). Preoperative steroid use was significantly associated with a lower hazard of surgical failure (criterion A: adjusted hazard ratio, 0.47; 95% CI: 0.27–0.82; P=0.008). Compared with the nonsteroid group, the steroid group exhibited greater bleb wall thickness (0.812 vs. 0.723 mm, P=0.038) and lower bleb wall reflectivity (130.3 vs. 141.9 arbitrary units, P=0.011).

Conclusions:: Preoperative administration of topical steroids, compared with no steroids, was associated with higher surgical success rates, thicker bleb walls, and lower bleb wall reflectivity on AS-OCT at 1 year.

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Cite

BibTeXRIS
BibTeX
@article{sunami2026preoperative,
  title = {{Preoperative Topical Steroid Use and Trabeculectomy Outcomes}},
  author = {Tasuku Sunami and Akiko Narita and Tomoe Miyake and Momoka Miyake and Etsuko Akimoto and Jiro Seguchi and Riku Akatsuka and Yuki Morizane},
  journal = {Journal of Glaucoma},
  year = {2026},
  month = oct,
  doi = {10.1097/ijg.0000000000002775},
  url = {https://doi.org/10.1097/ijg.0000000000002775},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Preoperative Topical Steroid Use and Trabeculectomy Outcomes
AU  - Tasuku Sunami
AU  - Akiko Narita
AU  - Tomoe Miyake
AU  - Momoka Miyake
AU  - Etsuko Akimoto
AU  - Jiro Seguchi
AU  - Riku Akatsuka
AU  - Yuki Morizane
PY  - 2026
DA  - 2026/10/16
JO  - Journal of Glaucoma
DO  - 10.1097/ijg.0000000000002775
UR  - https://doi.org/10.1097/ijg.0000000000002775
AB  - Précis:: Preoperative topical steroid use was associated with greater surgical success and thicker, less reflective bleb walls on anterior segment optical coherence tomography 1 year after trabeculectomy.  Purpose:: To assess the associations of preoperative topical steroid administration with surgical outcomes and filtering bleb morphology 1 year after trabeculectomy.  Patients and Methods:: This study included 304 eyes from 272 patients who underwent primary trabeculectomy with mitomycin C. Eyes were classified into steroid and nonsteroid groups based on preoperative topical steroid administration for 7 days. The primary outcome was surgical success at 1 year, defined by either criterion A [intraocular pressure (IOP) ≤15 mm Hg and a ≥20% reduction from preoperative IOP] or criterion B (IOP ≤12 mm Hg and a ≥30% reduction from preoperative IOP), achieved without glaucoma medication or additional glaucoma surgery. Bleb morphology was evaluated using anterior segment optical coherence tomography (AS-OCT). Multivariable Cox regression was used to adjust for potential confounders.  Results:: At 1 year, surgical success rates were significantly higher in the steroid group than in the nonsteroid group for both criterion A (85.5% vs. 71.1%, P=0.005) and criterion B (76.4% vs. 65.4%, P=0.040). Preoperative steroid use was significantly associated with a lower hazard of surgical failure (criterion A: adjusted hazard ratio, 0.47; 95% CI: 0.27–0.82; P=0.008). Compared with the nonsteroid group, the steroid group exhibited greater bleb wall thickness (0.812 vs. 0.723 mm, P=0.038) and lower bleb wall reflectivity (130.3 vs. 141.9 arbitrary units, P=0.011).  Conclusions:: Preoperative administration of topical steroids, compared with no steroids, was associated with higher surgical success rates, thicker bleb walls, and lower bleb wall reflectivity on AS-OCT at 1 year.
SN  - 1057-0829
SN  - 1536-481X
ER  -