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Early postoperative visual acuity changes after trabeculectomy and factors affecting visual acuity

  • Glaucoma
  • Published:
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Abstract

Purpose

To investigate the early visual acuity (VA) changes that occur after trabeculectomy and their reversal with recovery.

Method

Two hundred ninety-two eyes of 292 patients after initial trabeculectomy as a standalone procedure fulfilling the following conditions were included: 1) patients with a postoperative follow-up of at least 3 months; 2) patients with preoperative corrected VA less than 0.5 logMAR equivalent; 3) patients with reliable results of visual field; and 4) patients who had open angle glaucoma. VA and intraocular pressure (IOP) changes during the first 3 months after surgery and factors affecting VA postoperatively at 3 months were investigated.

Results

The mean IOPs (mmHg) after trabeculectomy were significantly lower than preoperatively during the entire period (P < 0.0001). The mean corrected VA for all patients was 0.06 ± 0.17, 0.24 ± 0.38, 0.19 ± 0.26, and 0.14 ± 0.27 preoperatively and at 1 week, 1 month, and 3 months postoperatively, respectively, showing a significant decrease from the preoperative period at all time points (P < 0.0001). VA loss of two or more levels was observed in 13 eyes (4.45%) at 3 months postoperatively. Foveal threshold (FT), shallow anterior chamber (SAC), and choroidal detachment (CD) affected the change in VA before and at 3 months after surgery (P < 0.0001, P = 0.0002, P = 0.0004, respectively). The factors that had significant effects on VA change were FT, SAC, and CD in POAG, FT and hypotonic maculopathy in NTG, and FT in XFG (p < 0.05).

Conclusion

The frequency of serious vision loss was 4.45% for two or more levels of vision loss, and early postoperative VA changes after trabeculectomy may not be reversed even 3 months later. VA loss is influenced by preoperative FT, postoperative SAC and CD, but the impact of postoperative complications vary with disease type.

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Authors and Affiliations

  1. Department of Ophthalmology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan

    Nobuyuki Sato, Masayuki Kasahara, Yusuke Kono, Kazunori Hirasawa & Nobuyuki Shoji

Authors
  1. Nobuyuki Sato
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  2. Masayuki Kasahara
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  3. Yusuke Kono
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  4. Kazunori Hirasawa
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Contributions

Nobuyuki Sato; designed the study and performed the experiments, collected data, wrote the manuscript.

Masayuki Kasahara; collected data, provided and cared for study patients.

Yusuke Kono; collected data, provided and cared for study patients.

Kazunori Hirasawa; served as scientific advisor.

Nobuyuki Shoji; critically reviewed the study proposal, wrote and edited the manuscript.

Corresponding author

Correspondence to Nobuyuki Shoji.

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All research procedures followed the Declaration of Helsinki. This study was approved by the Kitasato University Hospital Ethics Committee.

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Sato, N., Kasahara, M., Kono, Y. et al. Early postoperative visual acuity changes after trabeculectomy and factors affecting visual acuity. Graefes Arch Clin Exp Ophthalmol 261, 2611–2623 (2023). https://doi.org/10.1007/s00417-023-06076-3

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