Dietary tocopherol supplementation after trabeculectomy and phacotrabeculectomy : double-blind randomized placebo-controlled trial

PURPOSE: The vitamin E compound alpha-tocopherol inhibits fibroblast growth in vitro. To evaluate its potential benefit in preventing failure of glaucoma filtration surgery, we prospectively investigated the outcome of filtering surgery with postoperative dietary alpha-tocopherol supplementation. PATIENTS AND METHODS: Thirty-nine patients (39 eyes) with primary open-angle glaucoma or pseudoexfoliative glaucoma were randomly assigned to two post-(phaco)-trabeculectomy treatment groups. Daily oral intake of 300 mg alpha-tocopheryl-acetate (absorbed as alpha-tocopherol in the intestine) for 2 months was compared to a placebo preparation in a double-blind trial. The follow-up time was 1 year. Success was defined as intraocular pressure (IOP) >or=18 mm Hg with no medication, no needling revision, and no subconjunctival injection. RESULTS: In the tocopherol group, the relative risk for trabeculectomy failure decreased from 1.58 at 2 weeks (p = 0.95) to 1.0 at 1 year. Success rates (67-90%) and IOP reduction (mean 39 to 53%) were statistically comparable in the two groups. Considering postoperative complications, no relevant differences were found. DISCUSSION: Trabeculectomy and phacotrabeculectomy outcome did not show any differences between alpha-tocopherol-supplemented patients and the placebo group.