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Jimena Schmidt, Sylvia Araneda, Eugenia Abusleme, Claudio Perez, Eugenio Maul D., Eugenio Maul F., Andres Gerhard, Cecilia Trigo; Progression Rate Before and After Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5944.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the Visual Field (VF) progression rate (PR) before and after trabeculectomy.
Retrospective chart review of all patients with Primary Open Angle Glaucoma (POAG), Normal Tension Glaucoma (NTG), Pseudoexfoliation Glaucoma (GPEX) and Pigmentary Glaucoma (PG), who had trabeculectomy between 2000 and 2010. Patients who had at least 3 pre and 3 post surgery VF where included in the study, and their IOP measurements and medical treatment was noted.
We reviewed eyes with trabeculectomy between 2000-2010, 36 of them fullfilled study criteria. Glaucoma subtype was 63.89 % POAG, 19.44 % NTG, 11.11 % PEXG and 5.56 % PG. Average follow up was 8.01 (4.07- 14.13) years, 4.13 (+- 2.01) years pre and 3.87 (+- 1.49) years post operative. Prior to surgery, average IOP was 16.25 (11.3- 21.72) mmHg, VF MD -10.52 (+-5.26) dB and PR 1.19 dB/y; all patients under glaucoma medical therapy. Post surgery, average IOP was 10.5 (3.86- 16.6) mmHg, VF MD -13.15 (+-6.23) dB and PR was 0.23 dB/y, 41.6 % of patients having glaucoma medication. The pre and post surgery PR change were statistically significant (p=0.0000), not affected for the age of patients, severity of glaucoma and previous trabeculoplasty.Twenty-five eyes (69.4 %) had pre operative PR of 0.8 dB/y or higher, and their post trabeculectomy PR was 0.22 dB/y. Eleven eyes (30.56 %) had pre operative PR of 1.5 dB/y or higher, and their post trabeculectomy PR was 0.37 dB/y.Six percent trabeculectomy complications included blebitis (1) and resuture (1).
We observed a strong PR reduction after trabeculectomy, independent of age, pre operative VF MD and PR. This shows the protective effect of trabeculectomy in glaucoma patients, with 58.4 % eyes without needing glaucoma medication, and having a low progression rate.
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