Comparative Analysis of Penetrating and Non-Penetrating Glaucoma Surgery in Primary Open Angle Glaucoma

Abstract

OBJECTIVESPurpose analysis of safety and efficacy of Non-Penetrating Glaucoma Surgery (NPGS) for control and maintenance of intraocular pressure as compared to penetrating glaucoma surgery in Primary Open Angle Glaucoma (POAG) patients. DESIGNA hospital based randomized study. Participants 70, eyes of 70 POAG patients, 35 of which underwent NPGS and the remaining underwent Trabeculectomy surgery. MATERIALSNPGS and trabeculectomy was performed by standard surgical procedures after recording routine preoperative data. Patients were divided into 2 groups depending on the procedure they underwent. All patients were followed up after 1 week, 1 month, 3 months, 6 months and 12 months. Post-operative success was defined as IOP <21 mmHg at 1 month in absence of additional antiglaucoma medication or other treatment. RESULTSA significant reduction in intraocular pressure was observed post-surgery in both groups, changing from a preoperative mean of 31.09±7.37 mmHg and 29.26±7.10 mmHg to a postoperative mean of 15±3.06 mmHg and 14.85±4.22 mmHg respectively (P<0.001) at 12 months for trabeculectomy patients. It was seen that there was approximately constant reduction in all ranges of IOP, while for NPGS patient's best control in IOP was seen between at preoperative IOP between 21 to 30 mmHg. There was a significant difference in complications between two groups and the NPGS group had significantly less number of complications than the trabeculectomy group (p<0.05). However, the trabeculectomy group had a significantly lesser failure rate as compared to the NPGS group (p<0.05). CONCLUSIONTrabeculectomy though more effective for higher preoperative IOP, range is associated with greater risk of complications and hence for IOP range between 21 to 30 mmHg, NPGS would be the surgery of choice due to its equivalent efficacy and much greater safety standards.