Severe loss of central vision in patients with advanced glaucoma undergoing trabeculectomy

Document Type

Article

Department

Ophthalmology

Abstract

Research Objective: To evaluate the visual outcomes in patients with advanced visual field (VF) loss undergoing trabeculectomy with mitomycin C.
Study Design: A retrospective chart review.
Location: Jules Stein Eye Institute, Los Angeles, CA.
Funding Source: None listed. Relevant Methodology: The records of patients with severe preoperative VF defects undergoing trabeculectomy by 2 surgeons from June 1, 1998 to October 31, 2005 were retrospectively reviewed. The concept of “severe loss of vision” was defined before the start of the study.
Outcome Measures: In addition to severe loss of vision, the rate and nature of surgical complications associated with performing trabeculectomy with mitomycin C in patients with advanced glaucoma was evaluated.
Results: Central vision loss occurred in 7 of 117 patients/eyes (6%) due to various causes. A statistically significant mean VA reduction after surgery from −0.32 to −0.39 (log MAR, P=0.01) was found. Differences in visual parameters before and after surgery were not statistically significant. Patients who had severe loss of central vision had statistically significant higher mean±SD preoperative intraocular pressure (IOP) (27.1±8.8 mm Hg vs. 19.7±8.1 mm Hg; P=0.04) and higher rates of surgical complications (43% vs. 4%; P=0.001) compared with those who did not.
Conclusions: Severe loss of central vision after trabeculectomy with mitomycin C in glaucoma patients with marked VF loss was 6%. These patients also had higher preoperative IOP and higher rates of surgical complications. Unexplained severe loss of central vision (snuff out) was rare.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Evidence-Based Ophthalmology

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