Surgical Management of Normal Tension Glaucoma

  • Sarah S. KhodadadehEmail author
  • James C. Tsai
Part of the Essentials in Ophthalmology book series (ESSENTIALS)


Normal tension glaucoma is a progressive optic neuropathy that poses technical complexity in management to prevent vision loss. Surgical intervention is necessary when visual field progression is noted or imminent. Trabeculectomy with adjunct use of the anti-scarring agent mitomycin-C is the treatment of choice in achieving a target intraocular pressure to preserve vision in normal tension glaucoma patients. This subset of patients is at a relatively higher risk for dense visual field defects and postoperative surgical management is key to success for the patient and the surgeon. Other surgical interventions can be of aid in combination with each other or with traditional trabeculectomy and antimetabolite treatment to prevent fibrosis; however, these surgeries have not definitively resulted in intraocular pressures low enough to reach a desired target in normal tension glaucoma patients.


Normal tension glaucoma Low-tension glaucoma Glaucoma Intraocular pressure Surgery 



Conflict of interest: None to disclose

Compliance and ethical requirements: No animal or human studies were carried out by the authors for this article.

Compliance with ethical requirements: Dr. Khodadadeh and Dr. Tsai declare that they have no conflict of interest. No animal or human studies were carried out by the authors for this article.

Supplementary material

Video 10.1

Trabeculectomy with adjunctive Mitomycin-C; Sarah Khodadadeh, MD and James C. Tsai, MD, MBA (MV4 89,683 kb)


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Center for Advanced Eye CareVero BeachUSA
  2. 2.New York Eye and Ear Infirmary of Mount SinaiNew YorkUSA

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