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Central 10-degree visual field change following trabeculectomy in advanced open-angle glaucoma
T Fujishiro1, C Mayama, M Aihara
1Saitama Red Cross Hospital, Saitama, Japan.
Eye (London, England)
|April 16, 2011
Summary
Trabeculectomy surgery stabilized the central visual field (VF) in advanced open-angle glaucoma (OAG) patients. However, a small percentage experienced vision loss without clear causes.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Outcomes
Background:
- Advanced open-angle glaucoma (OAG) necessitates effective treatments to preserve vision.
- Trabeculectomy is a surgical option for managing intraocular pressure (IOP) in advanced glaucoma.
- Understanding the impact of trabeculectomy on the central visual field (VF) is crucial for patient management.
Purpose of the Study:
- To prospectively evaluate changes in the central 10-degree visual field (VF) over 12 months following trabeculectomy in patients with advanced open-angle glaucoma (OAG).
- To assess the correlation between surgical outcomes and potential risk factors.
- To monitor best-corrected visual acuity (BCVA) post-surgery.
Main Methods:
- A prospective interventional case series involving 27 eyes of 27 OAG patients.
- Patients had advanced glaucoma with a mean Humphrey VF 10-2 program total deviation of ≤-20 dB preoperatively.
- Intraocular pressure (IOP), VF parameters, and BCVA were monitored for 12 months after trabeculectomy with mitomycin C.
Main Results:
- Mean IOP significantly decreased from 19.7±5.8 to 9.7±2.6 mm Hg postoperatively (P<0.001).
- No significant changes were observed in central VF parameters over the 12-month follow-up period (P>0.33).
- A small proportion of patients (4-7%) experienced a ≥2 line decrease in BCVA without apparent cause.
Conclusions:
- Trabeculectomy effectively lowers IOP and shows minimal impact on the central 10-degree visual field in advanced OAG.
- Approximately 5% of patients may experience unexplained best-corrected visual acuity deterioration after surgery.
- Further investigation into the causes of BCVA decline in a subset of patients is warranted.
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