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Br J Ophthalmol 1999;83:305-310 doi:10.1136/bjo.83.3.305
  • Original Article
    • Clinical science

Course of exfoliation and simplex glaucoma after primary trabeculectomy

  1. Vladislav Popovica,b,
  2. Johan Sjöstrandb
  1. aSahlgrenska University Hospital, Department of Ophthalmology, Mölndal, Sweden, bDepartment of Ophthalmology, University of Gothenborg, Sweden
  1. Vladislav Popovic, Sahlgrenska University Hospital, Department of Ophthalmology, 431 80 Mölndal, Sweden.
  • Accepted 22 October 1998

Abstract

AIM To study the course of exfoliation and simplex glaucoma with respect to intraocular pressure (IOP) regulation and visual field survival after primary trabeculectomy.

METHODS Postoperative IOP regulation and complications were analysed prospectively in 95 patients. Mean follow up was 46 months. Visual field survival was studied by high pass resolution perimetry (HRP) in a subsample of 28 patients.

RESULTS Medical treatment was reinstated in 42% of exfoliation and in 36% of simplex glaucoma. In these patients, mean medicine free survival time, last untreated IOP, and mean IOP at the end of follow up were similar for both glaucoma types. Among patients with controlled postoperative IOP without added medication, mean IOP at the end of follow up was significantly lower in exfoliation glaucoma. Visual field deterioration and the pattern of complications were similar for both glaucoma types.

CONCLUSION The effect of trabeculectomy on IOP regulation was good in both types of glaucoma, and somewhat better in exfoliation glaucoma. The magnitude of IOP lowering could not separate patients with continued visual field deterioration from those in whom visual fields remained stable. Visual field preservation was similar for both glaucoma types.

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