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N. K. Rao, S. Bazzaz, S. Orengo-Nania; Effects of Guarded Filtration Surgery on Vision in an Elderly Population. Invest. Ophthalmol. Vis. Sci. 2007;48(13):843.
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To determine whether glaucoma patients over 70 years of age have significantly different outcomes in visual acuity and intraocular pressure after guarded filtration surgery when compared to patients under 70 years of age.
A retrospective chart review was performed for all patients at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas with a diagnosis of glaucoma who underwent guarded filtration surgery in one or both eyes within the past 10 years. A total of 322 charts were reviewed. Patients who had other surgical interventions at the time of guarded filtration surgery (such as cataract extraction), post-operative follow up less than one year in duration, or other ophthalmic disease limiting vision (such as severe proliferative diabetic retinopathy, retinal detachment, or neovascular glaucoma) were excluded. The 82 patients who met inclusion criteria were assigned to either the control group (age less than 70 years) or the study group (age 70 years and above). Pre- and post-operative data regarding visual acuity, lens status and intraocular pressure were collected.
There was no significant difference in visual acuity before and after guarded filtration surgery in all patients reviewed (p = 0.472), in patients under 70 years of age (p = 0.270), or in patients over 70 years of age (p = 0.662). There was also no significant difference in post-operative visual acuity between patients over 70 years of age and those under 70 years of age (p = 0.97). Of the charts with adequate intraocular pressure data at one year, 56% of patients over 70 years of age had a successful surgical outcome compared to only 42% of patients under 70 years of age.
After guarded filtration surgery, patients over 70 years of age did not have significantly different outcomes in visual acuity when compared with patients under 70 years of age. Therefore, guarded filtration surgery remains a good option for treatment of glaucoma refractory to medical therapy in patients of all age groups.
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