Abstract
Purpose: :
To evaluate the visual outcomes of patients with advanced visual field defects undergoing trabeculectomy.
Methods: :
The medical records of 1304 patients who had trabeculectomy between June 1998 and October 2005 (89 months) were retrospectively reviewed. Patients were excluded if they had uveitic glaucoma, neovascular glaucoma; nonglaucomatous optic nerve, cornea, or retinal diseases; or concurrent surgery with trabeculectomy. Patients were enrolled if the preoperative threshold automated visual field (24–2 or 30–2) had advanced defects defined as: >90% of the test points (excluding the central 4 test points) had sensitivities of <5dB or 3 of the 4 central test points were <5dB. One eye of each patient was enrolled. Outcome measurements include visual acuity, intraocular pressure, and surgical complications.
Results: :
85 patients (85 eyes) who met the above criteria were enrolled. 22 eyes (25.9%) had a decrease of > 1 line and 6 eyes (7.1%) had > 5 lines loss of Snellen visual acuity at 3 months postoperatively. There were no significant differences between the groups with and without a decrease in visual acuity of >1 line of reduction in Snellen visual acuity regarding to age, gender, glaucoma subtype, and IOP reduction. However, there was a significantly higher rate (28.2%) of surgical complications in patients with greater reduction in visual acuity than patients with less visual acuity decrease (7.1%, p=0.027).
Conclusions: :
Approximately 7% of glaucoma patients with advanced preoperative visual field defects undergoing trabeculectomy had a severe reduction of central vision, and is significantly associated with surgical complications.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: prevalence/incidence