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Trabeculectomy for normal tension glaucoma: outcomes using the Moorfields Safer Surgery technique
Hari Jayaram1, Nicholas G Strouthidis2, Deborah S Kamal3
1Glaucoma Service, Moorfields Eye Hospital, London, UK NIHR Biomedical Research Centre for Ophthalmology, UCL Institute of Ophthalmology & Moorfields Eye Hospital, London, UK Casey Eye Institute, Portland, Oregon, USA.
Trabeculectomy using modern techniques offers successful long-term outcomes for normal tension glaucoma (NTG) patients, with significantly fewer complications than previously reported. This surgical approach demonstrates a favorable safety and efficacy profile for managing NTG.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Outcomes
Background:
- Normal tension glaucoma (NTG) presents a diagnostic and therapeutic challenge.
- Trabeculectomy is a common surgical intervention for glaucoma.
- Evaluating long-term outcomes of trabeculectomy in NTG is crucial.
Purpose of the Study:
- To assess the long-term efficacy and safety of trabeculectomy in normal tension glaucoma patients.
- To evaluate outcomes using contemporary surgical techniques and intensive postoperative management.
- To compare complication rates with existing literature.
Main Methods:
- Retrospective analysis of 131 eyes from 98 patients with NTG undergoing trabeculectomy.
- Data collected from 2007-2013 in a dedicated NTG clinic.
- Kaplan-Meier analysis used to evaluate intraocular pressure (IOP) reduction, bleb function, glaucoma progression, and complications.
Main Results:
- High cumulative success rates at 4 years (e.g., 62.1% for ≥30% IOP reduction).
- Low rates of postoperative complications, including hypotony (2.3% early, 0.8% late).
- No significant association found between previous cataract surgery or ethnicity and failure at 2 years.
Conclusions:
- Trabeculectomy with contemporary techniques and intensive management yields successful long-term outcomes in NTG.
- This approach demonstrates a lower complication profile than previously suggested in the literature.
- Effective IOP control and reduced progression observed in NTG patients.
