Five-year results favor trabeculectomy in advanced glaucoma
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Patients with advanced glaucoma should be offered trabeculectomy as their primary intervention, according to a study presented at the American Glaucoma Society meeting.
Anthony King, MD, presented data from the Treatment of Advanced Glaucoma Study in the United Kingdom.
“People presenting with advanced glaucoma are those people most likely to go blind during their lifetime,” he said. “There is some uncertainty about what the best primary intervention is.”
In the study, 453 patients with recently diagnosed advanced glaucoma were randomly assigned to undergo primary trabeculectomy augmented with mitomycin C or primary medical treatment with glaucoma drops.
Through 5 years, there was no material difference in quality of life outcomes between the two groups.
However, for clinical outcomes, there was an almost immediate difference in IOP control that was sustained through 5 years in favor of the trabeculectomy group compared with the medical treatment group. In addition, there was a clinically important difference in visual field progression favoring the trabeculectomy group starting around 2.5 years, with the difference between the groups increasing over 5 years.
There were no material differences in adverse events between the two groups, and both interventions are safe, King said.
“On the basis of this, we therefore suggest or recommend that patients presenting with advanced glaucoma should be offered trabeculectomy augmented with mitomycin C as their primary intervention,” he said.
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King A. Treatment of Advanced Glaucoma Study 5-year results. Presented at: American Glaucoma Society meeting; Feb. 29-March 3, 2024; Huntington Beach, California (hybrid meeting).
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