Outcomes of trabeculectomy for primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Outcomes

Background:

• Primary open-angle glaucoma is a leading cause of irreversible blindness.
• Trabeculectomy is a common surgical intervention to lower intraocular pressure.
• Long-term efficacy and structural outcomes of trabeculectomy require further investigation.

Purpose of the Study:

• To evaluate the long-term functional and structural outcomes of trabeculectomy in patients with primary open-angle glaucoma.
• To assess the rate of progressive glaucomatous damage after initial trabeculectomy.

Main Methods:

• Retrospective study of 78 patients (78 eyes) undergoing their first trabeculectomy.
• Follow-up duration ranged from 25 to 112 months.
• Serial automated perimetry and stereoscopic optic disc photography were used to assess glaucomatous damage progression.

Main Results:

• No progressive glaucomatous damage was observed in 81% (3 years) and 65% (6 years) of eyes.
• Visual field deterioration occurred in 21% of eyes; progressive optic nerve damage in 5%.
• Successful intraocular pressure control probability was 48% at 3 years and 40% at 5 years.

Conclusions:

• Progressive glaucomatous damage occurs in approximately one-third of eyes with moderate to severe primary open-angle glaucoma within 6 years post-trabeculectomy.
• Trabeculectomy demonstrates potential for preventing glaucomatous progression, but long-term monitoring is crucial.
• Further glaucoma surgery was required in 25% of cases, highlighting the need for individualized treatment strategies.