Trabeculectomy and postoperative ocular hypertension in secondary angle-closure glaucoma.

I performed trabeculectomies to reduce the introacular pressure to 20 mm Hg or lower, in 56 eyes with medically uncontrollable primary open-angle glaucoma or secondary angle-closure glaucoma. In the former group, I achieved success in 85% of cases, 65% without further antiglaucomatous therapy. In the latter group, 59% obtained a successful result, 41% without additional treatment. The readings of applanation tonometry on the first postsurgical day were compared to those obtained after one year. Although approximately 50% of eyes in both glaucoma categories had an initially elevated pressure after trabeculectomy, it decreased steadily in most of those with primary open-angle glaucoma. In the secondary angle closure glaucoma population, this immediate postoperative ocular hypertension was significantly correlated with eventual failure of the operation.