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'Clean' trabeculectomy prevents vision loss in some advanced glaucoma cases
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STOCKHOLM, Sweden — Performing trabeculectomy with careful postoperative care and as minimal intraoperative manipulation as possible can assist in vision loss prevention in advanced glaucoma cases, one surgeon said.
Shishir Agrawal, MS, DNB, FRCS, and colleagues conducted a prospective study of 200 eyes with 5° or less of remaining visual fields due to advanced glaucomatous damage. He presented the findings at the European Society of Cataract and Refractive Surgeons meeting. All patients had a standard trabeculectomy performed without an antifibrotic agent. Follow-up was 1 month to 1 year. There was cataract progression in eight cases and uveitis in five, Dr. Agrawal said.
All patients who had advanced glaucoma had stabilization of glaucoma-related visual acuity and IOP following surgery, he said.
"We always recommend a filtration surgery in end-stage glaucoma, and find it very successful, and now have a very long follow-up of these cases, doing very well, the vision preserved and IOP lowered considerably," he said. "We feel that it should be made a standard practice to operate such cases, so that the last bit of the important vision remains intact."