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Abstract
Introduction: Beta-irradiation after trabeculectomy is one of the most important
methods to enhance the results of this surgery, especially where exceptionally high
expectation of failure exists. It hinders fibrosis of the flap door and the surgical route
after surgery, hence elongating the life span of the bleb. It is easy to use, with no much
complications if used within the safe dose, giving results comparable to other methods.
Objective: to evaluate the rule of beta-radiation as a method of enhancing
results of trabeculectomy in high risk glaucoma patients if used as a single dose or
fractioned dose post operatively.
Patients and methods: 90 patients were randomly grouped in 3 groups each of
30 patients. All patients were selected out of those diagnosed as high risk glaucoma
patients. Either young or blacks or having neovascular glaucoma or being for long time on
antiglaucoma topical treatment, or had their eyes chronically inflamed, or suffering
xerophthalmia and kept for a long time on preserved artifical tears. The groups were named
A, B, C. Group A: the control group, had no irradiation after surgery, group B: had single
total dose of 21 00 cGy just after closure of the conjunctiva. Group C: had 3 divisions of the
total dose each of700 cGy, being applied every week starting at the day of surgery.
Results: each patient had a follow up period of9 months. Trabeculectomy per se
was proved to be very effective in reducing lOP. Single intra-operative does of
2100 cGy beta-radiation was proved to be the most effective mode of application
through this study. Fractioned dose application still considered effective, but not so
effective as a single dose. To little lower success rate, it also enhanced bleb survival of
high risk glaucoma patients.
Conclusion: the application of beta-radiation after trabeculectomy is a quite safe
method for both patient and surgeon. It gets bleb failure rate down to a better level than
that after trabeculectomy per se. it also gets the postoperative lOP in succeeded cases at
a lower, safer and more convenient level than succeeded cases without irradiation. It
carries no special hazards or serious complications.