OUTCOMES OF TRABECULECTOMY FOR PRIMARY OPEN-ANGLE GLAUCOMA

Purpose: To determine the long-term functional and structural outcomes in patients treated with trabeculectomy for primary open-angle glauco ma. Methods: Records of 78 consecutive patients (78 eyes) who had thei r first trabeculectomy were studied retrospectively (duration of follo w-up, 25 to 112 months), Serial automated perimetry and stereoscopic o ptic disc photographs were used to assess the long-term efficacy of tr abeculectomy to prevent progressive glaucomatous damage. Stereoscopic optic disc photographs were available for 29 eyes (38%). Criteria for intraocular pressure control were a minimum intraocular pressure reduc tion of 20% and intraocular pressure at or below 20 mmHg. Results: The re was no evidence of progression of glaucomatous damage in 81% and 65 % of the eyes after 3 and 6 years, respectively, The visual field dete riorated in 16 eyes (21%) and progressive structural optic nerve damag e occurred in 4 eyes (5%) during follow-up. Deterioration of the optic nerve head in the absence of visual field progression was detected in three (4%) of those eyes. In 19 eyes (25%), further glaucoma surgery was performed. The probability of successful intraocular pressure cont rol after a single operation was 48% and 40% at 3 and 5 years, respect ively. Conclusion: Progressive glaucomatous damage occurs in about one third of eyes with moderate to severe primary open-angle glaucoma ove r a 6-year follow-up after trabeculectomy.