Severe loss of central vision in patients with advanced glaucoma undergoing trabeculectomy
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.
Publication ( Name of Journal)
Damji, K. F.,
(2008). Severe loss of central vision in patients with advanced glaucoma undergoing trabeculectomy. Evidence-Based Ophthalmology, 9(1), 24-25.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_ophthalmol/85