Outcomes of Trabeculectomy in Africa

Purpose: To determine the outcome of trabeculectomy in African countries. Design: This is a review of literature for trabeculectomy conducted in Africa from 2000 to December 2012. Methods: We conducted an electronic search from the following databases: PubMed, Science Direct, Google, and Google scholar websites for the articles of original studies on trabeculectomy conducted in Africa. Results: A total of 109 articles, published from 2000 to December 2012 were retrieved. Only 12 articles met our inclusion criteria and were included in the study. The follow-up duration ranged from 6 months to 60 months. The post-trabeculectomy IOP range was 10 mmHg to 22 mmHg with rates varying from 61.8% to 90%. The visual acuity was unchanged among 19% to 30% of the participants in the last follow-up, and the improvement rate was 36% to 81.5% while those whose condition worsened ranged from 8.9% to 30.8%. The cup-disc ratio was ≤0.5 in 13% and ≥0.8 in 83% of the participants. The failure rate of the c/d ratio was 0.9 and it increased by 0.027 units. There was a follow-up of only one study on the visual field. Conclusion: Trabeculectomy with or without application of antimetabolite appears to be a good way to lowering the IOP in Africa. In addition, the combined effect of trabeculectomy and cataract surgery produces visual benefits for the patients.