Achieving low target intraocular pressures in severe glaucoma.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Ocular Surgery

Background:

• Severe glaucoma necessitates aggressive management to prevent vision loss.
• Intraocular pressure (IOP) control is paramount in glaucoma therapy.
• Understanding treatment requirements for target IOP is crucial for patient outcomes.

Purpose of the Study:

• To determine the therapeutic interventions needed to achieve an intraocular pressure (IOP) of 12 mmHg or less in patients with severe glaucoma.
• To analyze the relationship between baseline IOP, patient demographics, visual field status, and treatment outcomes.

Main Methods:

• Retrospective analysis of 127 eyes from 85 patients with severe glaucoma and at least a 1-year follow-up.
• Data collected included baseline and final IOP, number of medications, and surgical procedures required to achieve target IOP (⩽12 mmHg).
• Statistical analysis compared treatment needs across different glaucoma types, age groups, baseline IOP levels, and visual field statuses.

Main Results:

• Only 21.26% of severe glaucoma cases were controlled with medication alone.
• Higher baseline IOP (>25 mmHg) significantly correlated with increased need for surgery (trabeculectomy).
• Younger patients (<40 years) and those with worse visual field mean deviation (>-16 dB) also showed a higher frequency of surgical intervention.

Conclusions:

• Achieving an IOP of 12 mmHg or less in severe glaucoma frequently requires surgical intervention, particularly in cases with high baseline IOP, younger age, or advanced visual field loss.
• Medication alone is insufficient for the majority of severe glaucoma patients.
• Trabeculectomy is a common surgical procedure for achieving target IOP in this patient cohort.