Course of exfoliation and simplex glaucoma after primary trabeculectomy

Aim-To study the course of exfoliation and simplex glaucoma with respect to intraocular pressure (IOP) regulation and visual field survival after prim ary trabeculectomy. Methods-Postoperative IOP regulation and complications were analysed prospe ctively 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 p atients. Results-Medical treatment was reinstated in 42% of exfoliation and in 36% o f simplex glaucoma. In these patients. mean medicine free survival time, la st untreated IOP, and mean IOP at the end of follow up were similar for bot h 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 comp lications 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 magnitu de of IOP lowering could not separate patients with continued visual field deterioration from those in whom visual fields remained stable. Visual fiel d preservation was similar for both glaucoma types.