PURPOSE: This study investigated the association between one-year surgical outcomes following trabeculectomy and age, accounting for confounding factors. STUDY DESIGN: Retrospective observational study. METHOD: Analyzing data from 305 patients undergoing initial trabeculectomy from 2019 onward, we employed three approaches to adjust variables: stratified analysis, regression analysis, and propensity score matching. Surgical success at 1-year post-surgery was defined by two criteria: achieving intraocular pressure of between 5 and 15 mmHg with a ≥ 20% reduction compared to pre-surgery levels and no additional glaucoma surgery (Criterion A)
achieving intraocular pressure of between 5 and 12 mmHg with a ≥ 30% reduction compared to pre-surgery levels and no additional glaucoma surgery (Criterion B). RESULTS: Stratified analysis by age unveiled a significant increase in exfoliation glaucoma (XFG) and a trend towards shorter axial lengths with advancing age (both p <
0.0001). Older age groups were more likely to experience surgical failure in both Criterion A and B (p = 0.21, <
0.01). Univariate analysis showed age as a significant factor in surgical failure for Criterion A (p <
0.05) and a nearly significant factor for Criterion B (p = 0.12). However, this trend was not evident in multivariate analysis (p = 0.23/0.88), where XFG became a significant factor for surgical failure (both p <
0.001) in Criteria A and B. Propensity score matching revealed no significant differences in surgical success rates for Criteria A and B between younger and older patients (p = 1.00 and 0.88). CONCLUSION: Age is not a primary determinant of failure in trabeculectomy
however, the increasing incidence of XFG with aging suggests a potential for poorer outcomes.