The long-term outcome of glaucoma filtration surgery☆
Section snippets
Methods
This study is a retrospective, community-based, longitudinal study of residents of Olmsted County, Minnesota, who were newly diagnosed with open-angle glaucoma between 1965 and 1980, and underwent filtration surgery in these or subsequent years through July 1999. The time period for inclusion of patients in this cohort was chosen to allow for adequate long-term follow-up after diagnosis and surgery. Note that treatment and follow-up continued throughout the period from 1965 to 1999.
Study
Results
A total of 84 eyes from 58 patients underwent filtration surgery. The majority had primary open angle glaucoma (POAG) (67%: 39/58 patients), followed by pseudoexfoliative glaucoma (21%: 12/58 patients), low tension glaucoma (3 patients), pigmentary glaucoma (2 patients), juvenile, and neovascular glaucoma (1 patient each). Over half were female (64%: 37/58). The mean age at first filtrating surgery was 71 ± 14 years (median: 76 years). The median follow-up time postoperatively was 8 years with
Discussion
A slow progression to legal blindness occurred in some patients despite filtration surgery. Kaplan-Meier survival analysis, which accounts for variable follow-up periods, calculates a 22% probability of blindness at 5 years and a 46% probability at 10 years. The IOP in patients going blind was usually equal to or lower than in patients not becoming blind at each time point. Preoperative field loss was more extensive in patients becoming blind, however, with scotomas both above and below the
References (25)
- et al.
The place of trabeculectomy in the treatment of glaucoma
Ophthalmology
(1981) - et al.
The collaborative initial glaucoma treatment study
Ophthalmology
(1999) - et al.
The probability of blindness from open angle glaucoma
Ophthalmology
(1998) History of the Rochester Epidemiology Project
Mayo Clin Proc
(1996)- et al.
Rate of progression in open-angle glaucoma estimated from cross-sectional prevalence of visual field damage
Am J Ophthalmol
(1996) - et al.
Late onset of sequential multifocal bleb leaks after glaucoma filtration surgery with 5-fluorouracil and mitomycin C
Am J Ophthalmol
(1997) - et al.
Late bleb-related endophthalmitis after trabeculectomy with adjunctive 5-fluorouracil
Ophthalmology
(1991) - et al.
Bleb-related endophthalmitis after trabeculectomy with mitomycin C
Ophthalmology
(1996) - et al.
Late endophthalmitis-filtering surgery time bomb?
Ophthalmology
(1996) - et al.
Otago glaucoma surgery outcome study. Long-term results of trabeculectomy 1976–1995
Ophthalmology
(1999)
Long-term follow-up of initially successful trabeculectomy
Ophthalmology
Long-term evaluation of initial filtration surgery
Ophthalmology
Cited by (0)
- ☆
Supported in part by National Institutes of Health research grant EY 07065, an unrestricted grant from Research to Prevent Blindness, Inc., New York, NY, The Bonner Foundation, Princeton, NJ, and Mayo Foundation, Rochester, MN.