April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Comparison Of The Rates Of Visual Field Loss Before And After Primary Trabeculectomy
Jonathan D. Tung; Mauro T. Leite; Robert N. Weinreb; Linda M. Zangwill; Pamela A. Sample; Felipe A. Medeiros
Author Affiliations & Notes
  • Jonathan D. Tung
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California - San Diego, La Jolla, California
  • Mauro T. Leite
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California - San Diego, La Jolla, California
  • Robert N. Weinreb
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California - San Diego, La Jolla, California
  • Linda M. Zangwill
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California - San Diego, La Jolla, California
  • Pamela A. Sample
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California - San Diego, La Jolla, California
  • Felipe A. Medeiros
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California - San Diego, La Jolla, California
  • Footnotes
    Commercial Relationships  Jonathan D. Tung, None; Mauro T. Leite, None; Robert N. Weinreb, Alcon (C), Allergan (C), Carl Zeiss Meditec (F, C), Heidelberg Engineering GmbH (F), Merck (C), Novartis (F), Optovue (F, C), Pfizer (C), Topcon Medical Systems (F); Linda M. Zangwill, Carl Zeiss Meditec (F), Heidelberg Engineering (R), Heidelberg Engineering GmbH (F), Optovue (F), Topcon Medical Systems (F); Pamela A. Sample, Carl Zeiss Meditec (F), Haag-Streit (F); Felipe A. Medeiros, Alcon Laboratories Inc (F, C, R), Allergan (C, R), Carl Zeiss Meditec (F, R), Merck (F), Pfizer (F, C, R), Reichert (R)
  • Footnotes
    Support  NEI EY11008, NEI EY08208, and participant retention incentive grants in the form of glaucoma medication at no cost from Alcon Laboratories Inc, Allergan, Pfizer Inc, and Santen Inc.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4409. doi:
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      Jonathan D. Tung, Mauro T. Leite, Robert N. Weinreb, Linda M. Zangwill, Pamela A. Sample, Felipe A. Medeiros; Comparison Of The Rates Of Visual Field Loss Before And After Primary Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4409.

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Abstract

Purpose: : To compare the rates of visual field loss before and after successful primary trabeculectomy.

Methods: : This was a longitudinal observational study. All participants were recruited from the Diagnostic Innovations in Glaucoma Study (DIGS). To be included, patients had to have a minimum of 8 reliable visual fields (4 before and 4 after the surgery) and a follow-up of at least 4 years. All participants had open angles at presentation. Indications for trabeculectomy included evidence of progressive glaucomatous damage and/or uncontrolled intraocular pressure (IOP). Trabeculectomies were performed with mitomycin-C (69%), fluorouracil (21%), or neither (10%) at the discretion of the surgeon. Surgeries were considered successful if the mean post-operative IOP was at least 20% less compared to the mean pre-operative IOP. Rates of visual field loss before and after trabeculectomy were calculated using visual field mean deviation (MD) change over time. Linear mixed models were built to evaluate the effect of surgery on the rates of visual field loss over time. Estimates of the rates of change before and after surgery for individual eyes were obtained by best linear unbiased prediction (BLUP).

Results: : Twenty-nine eyes from 27 patients with successful trabeculectomy were included. The mean ± SD follow-up time was 11.2 ± 3.5 years (range 5 to 19 years). The average pre-operative IOP was significantly higher than the average post-operative IOP (20.8 ± 5.6 mmHg vs 9.0 ± 3.3 mmHg; P<0.001). The average IOP reduction was 11.8 mmHg ± 5.3 (range 3.2 mmHg to 22.6 mmHg). The rate of MD change before the procedure was -0.31 dB/year, significantly greater than the -0.05 dB/year after trabeculectomy (P=0.03).

Conclusions: : Trabeculectomy resulting in at least a 20% reduction in IOP was effective in reducing the rates of visual field progression in our population.

Clinical Trial: : http://www.clinicaltrials.gov NCT00221897

Keywords: intraocular pressure • visual fields 
© 2011, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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