Abstract
Purpose
To review the surgical results and complications of trabeculectomy techniques in patients with advanced glaucoma and threatened fixation.
Methods
Trabeculectomy had been carried out on 49 advanced glaucoma patients (49 eyes) using mitomycin C and postoperative laser suture lysis. The clinical records prior to and 2 months after surgery were reviewed, and the long-term surgical outcomes were determined.
Results
Two months after surgery there were no eyes with fixation loss. Intraocular pressure (IOP) levels were reduced from 22.8 ± 6.0 to 11.7 ± 4.7 mmHg. Kaplan-Meier survival analysis showed that the success rate in achieving IOPs of 15 mmHg or lower 5 years after surgery was 70%. The chance of visual acuity remaining within two lines of the preoperative level was 75%. In 29 of the 49 eyes, visual acuities remained at their preoperative level at the time of the final visit, but had decreased to less than 0.1 in three eyes (cataract progression, n = 2; fixation loss, n = 1).
Conclusion
The results suggest that laser suture lysis and stepwise management of IOP levels, which are performed as part of the modern postoperative management of trabeculectomy, decrease the frequency of fixation loss during the early postsurgical phase. Jpn J Ophthalmol 2007;51:116–120 © Japanese Ophthalmological Society 2007
Similar content being viewed by others
References
AE Kolker (1977) ArticleTitleVisual prognosis in advanced glaucoma: a comparison of medical and surgical therapy for retention of vision in 101 eyes with advanced glaucoma Trans Am Ophthalmol Soc 75 539–555 Occurrence Handle613530 Occurrence Handle1:STN:280:DyaE1c7otFyktQ%3D%3D
SP Aggarwal S Hendeles (1986) ArticleTitleRisk of sudden visual loss following trabeculectomy in advanced primary open-angle glaucoma Br J Ophthalmol 70 97–99 Occurrence Handle3947617 Occurrence Handle1:STN:280:DyaL287jtFGnsw%3D%3D
HS Gradle (1936) The eye and its diseases C Berens (Eds) Glaucoma W. B. Saunders Philadelphia 699–733
LJ Katz GL Spaeth (1989) Filtration surgery R Ritch MB Shields T Krupin (Eds) The glaucomas Mosby St. Louis 653–696
DO Harrington (1976) Glaucoma. The visual fields. A textbook and atlas of clinical perimetry Mosby St. Louis 178–214
GA Lawrence (1969) ArticleTitleSurgical treatment of patients with advanced glaucomatous field defects Arch Ophthalmol 81 804–807 Occurrence Handle5783751 Occurrence Handle1:STN:280:DyaF1M3gt1yhuw%3D%3D
PR Lichter JG Ravin (1974) ArticleTitleRisks of sudden visual loss after glaucoma surgery Am J Ophthalmol 78 1009–1013 Occurrence Handle4440714 Occurrence Handle1:STN:280:DyaE2M%2FntV2ktA%3D%3D
EJ O'Connell AG Karseras (1976) ArticleTitleIntraocular surgery in advanced glaucoma Br J Ophthalmol 60 124–131 Occurrence Handle1268172
J Otto (1957) ArticleTitleLoss of point of fixation after glaucoma surgery Klin Monatsbl Augenheilkd 131 178 Occurrence Handle1:STN:280:DyaG1c%2FisVyksg%3D%3D
PC Kronfeld HI McGarry (1948) ArticleTitleFive year follow-up of glaucomas JAMA 136 957 Occurrence Handle1:STN:280:DyaH1c%2FltVCisw%3D%3D
S Bloomfield L Kellerman (1949) ArticleTitleTherapeutic results in advanced chronic simple glaucoma with telescopic fields Am J Ophthalmol 32 1177 Occurrence Handle1:STN:280:DyaH1M%2FksVGrtw%3D%3D Occurrence Handle18143008
J Vossen H Neubauer (1984) ArticleTitleLong-term observations after trephination with scleral flap in glaucoma with threatened point of fixation Ophthalmologica 189 169–176 Occurrence Handle6514276 Occurrence Handle1:STN:280:DyaL2M%2Foslajug%3D%3D Occurrence Handle10.1159/000309407
VP Costa M Smith GL Spaeth S Gandham B Markovitz (1993) ArticleTitleLoss of visual acuity after trabeculectomy Ophthalmology 100 599–612 Occurrence Handle8493002 Occurrence Handle1:STN:280:DyaK3s3mtFKksA%3D%3D
JA Martinez RH Brown MG Lynch MB Caplan (1993) ArticleTitleRisk of postoperative visual loss in advanced glaucoma Am J Ophthalmol 115 332–337 Occurrence Handle8442492 Occurrence Handle1:STN:280:DyaK3s7ot1Oiug%3D%3D
TM Eid GL Spaeth A Bitterman WC Steinmann (2003) ArticleTitleRate and amount of visual loss in 102 patients with open-angle glaucoma followed up for at least 15 years Ophthalmology 110 900–907 Occurrence Handle12750087 Occurrence Handle10.1016/S0161-6420(03)00076-9
RZ Levene (1992) ArticleTitleCentral visual field, visual acuity, and sudden visual loss after glaucoma surgery Ophthalmic Surg 23 388–394 Occurrence Handle1513534 Occurrence Handle1:STN:280:DyaK38zot1ymtg%3D%3D
K Jian H Tsukamoto K Okada et al. (2001) ArticleTitleOutcome of initial trabeculectomy with mitomycin C in advanced glaucoma (in Japanese, with English abstract) Atarashii Ganka (J Eye) 18 502–504
K Ohtsuka M Hashimoto Y Suzuki (2005) ArticleTitleVisual field defects associated with sick sinus syndrome Jpn J Ophthalmol 49 59–61 Occurrence Handle15692778 Occurrence Handle10.1007/s10384-004-0138-z
MB Wax G Tezel I Saito et al. (1998) ArticleTitleAnti-Ro/SS-A positivity and heat shock protein antibodies in patients with normal-pressure glaucoma Am J Ophthalmol 125 145–157 Occurrence Handle9467439 Occurrence Handle10.1016/S0002-9394(99)80084-1 Occurrence Handle1:STN:280:DyaK1c7ivVGntw%3D%3D
RK Sullivan E Woldemussie L Macnab G Ruiz DV Pow (2006) ArticleTitleEvoked expression of the glutamate transporter GLT-1c in retinal ganglion cells in human glaucoma and in a rat model Invest Ophthalmol Vis Sci 47 3853–3859 Occurrence Handle16936097 Occurrence Handle10.1167/iovs.06-0231
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Awai, M., Koga, T., Inatani, M. et al. Stability of the Central Visual Field After Modern Trabeculectomy Techniques in Eyes with Advanced Glaucoma. Jpn J Ophthalmol 51, 116–120 (2007). https://doi.org/10.1007/s10384-006-0418-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10384-006-0418-x