Is filtering surgery in glaucoma patients with advanced visual field loss associated with an increased risk of postoperative functional loss?

Background: We evaluated the prevalence of the loss of visual acuity due to loss of the central portion of the visual field and foveolar fixation in t he first week after glaucoma filtering surgery. Patients and methods: We included 408 patients, in whom glaucoma filtering surgery was performed between January 1993 and April 1997 at the University Eye Clinic in Tubingen and who had completed 1-year follow-up examinations . The retrospective evaluation included preoperative, intraoperative and po stoperative data. We excluded all patients who did not complete 1-year foll ow-up examinations (12+/-3 months),who have died during the 1-year follow-u p,who had combined glaucoma and cataract surgery or in whom the Molteno imp lant procedure was performed. Results: A total of 404 patients (99.3%) did not suffer loss of the central visual field and foveolar fixation in the first week after glaucoma filter ing surgery. In 11 cases, loss of visual acuity >2 dB was due to progressiv e lens opacification. One patient suffered from postoperative progression o f his age-related maculopathy. In one patient (0.2%) progression of a preex isting relative central scotoma occurred immediately after the operation. T wo patients (0.5%) suffered from loss of fixation and the central visual fi eld immediately after glaucoma filtering surgery. Conclusions: Loss of the central visual field and central fixation immediat ely after glaucoma filtering surgery is a rare complication. Therefore,glau coma filtering surgery can also be recommended for patients with advanced v isual field defects.