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. 2016 Feb;25(2):217-22.
doi: 10.1097/IJG.0000000000000145.

Safety And Efficacy Of Achieving Single-Digit Intraocular Pressure Targets With Filtration Surgery In Eyes With Progressive Normal-Tension Glaucoma

Scott K Schultz  1 , Shawn M Iverson, Wei Shi, David S Greenfield
Affiliations

Safety And Efficacy Of Achieving Single-Digit Intraocular Pressure Targets With Filtration Surgery In Eyes With Progressive Normal-Tension Glaucoma

Scott K Schultz et al. J Glaucoma. 2016 Feb.

Abstract

Purpose: Whereas achieving intraocular pressure (IOP) targets ≤ 10 mm Hg typically requires surgical intervention, we sought to examine the safety and efficacy of trabeculectomy in normal-tension glaucoma (NTG).

Methods: Patients with progressive NTG undergoing trabeculectomy with preoperative IOP ≤ 15 mm Hg during the 12-month period before surgery were identified at a single academic institution. Failure was defined as IOP reduction <20% below baseline (criteria A), <30% (criteria B), or <40% (criteria C), reoperation for glaucoma, or loss of light perception vision.

Results: Thirty eyes of 28 patients (mean age, 73 ± 8.7 y) were enrolled with a mean follow-up period of 50 ± 31 months. Mean postoperative IOP (8.6 ± 2.9 mm Hg) and medications (0.6 ± 1.0) at final follow-up was significantly (P<0.001) reduced compared with before surgery (13.2 ± 1.4 mm Hg and 2.5 ± 1.2, respectively). The cumulative probability of failure during 5 years of follow-up was 32% (criteria A), 48%, (criteria B), and 67% (criteria C). The probability of successfully achieving an IOP goal ≤ 10 mm Hg was 68% at 4 years of follow-up.

Conclusions: Trabeculectomy is a safe and effective method for achieving single-digit IOP targets in NTG eyes with progression at low IOP.

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Figures

Figure 1
Figure 1
Kaplan-Meier plot of the cumulative probability of Qualified Success, defined as intraocular pressure (IOP) reduction ≥ 20% below baseline (criteria A), ≥ 30% below baseline (criteria B), ≥ 40% below baseline (criteria C), at the various postoperative follow-up time points, with or without anti-glaucomatous medications. *Note: Total eyes at each follow-up.
Figure 2
Figure 2
Kaplan-Meier plot of the cumulative probability of Complete Success, defined as intraocular pressure (IOP) reduction ≥ 20% below baseline (criteria A), ≥ 30% below baseline (criteria B), ≥ 40% below baseline (criteria C), at the various postoperative follow-up time points, without anti-glaucomatous medications. *Note: Total eyes at each follow-up.
See this image and copyright information in PMC

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