Outcomes of Trabeculectomy for Primary Open-angle Glaucoma

Nouri‐Mahdavi, Kouros; Brigatti, L.; Weitzman, Marc; Caprioli, Joseph

doi:10.1016/s0161-6420(95)30796-8

Cited by 154 publications

(93 citation statements)

References 35 publications

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“…6 Early PLR criteria were arbitrary, and the investigators using them had no 'gold standard' to use, a situation that persists. The criteria chosen required one [6][7][8][9][10][11] or two points 12,13 to be changing. The minimum critical slope was specified as being o0 dB/year, 8,9,13 oÀ1 dB/ year, 6,10,12 oÀ2.4 dB/year 7 or onormal age decline.…”

Section: Introductionmentioning

confidence: 99%

“…The criteria chosen required one [6][7][8][9][10][11] or two points 12,13 to be changing. The minimum critical slope was specified as being o0 dB/year, 8,9,13 oÀ1 dB/ year, 6,10,12 oÀ2.4 dB/year 7 or onormal age decline. 11 The level of significance or P-value used has not always been reported; 11,12 but where it has, the values chosen have been Po0.0009, 13 Po0.001, [8][9][10] and Po0.05.…”

Section: Introductionmentioning

confidence: 99%

“…The minimum critical slope was specified as being o0 dB/year, 8,9,13 oÀ1 dB/ year, 6,10,12 oÀ2.4 dB/year 7 or onormal age decline. 11 The level of significance or P-value used has not always been reported; 11,12 but where it has, the values chosen have been Po0.0009, 13 Po0.001, [8][9][10] and Po0.05. 6,7 Criteria from some of the studies mentioned above were used to analyse the visual fields from the UK Medical Research Council (MRC)/Moorfields 5-FU Filtration (More flow) Surgery Study.…”

Section: Introductionmentioning

confidence: 99%

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Pointwise linear progression criteria and the detection of visual field change in a glaucoma trial

Wilkins

Fitzke²,

Khaw

2005

Eye

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Background Current pointwise linear regression (PLR) change criteria for visual field analysis are largely empirical. Methods Two independent sets of Humphrey Field Analyzer fields were analysed using PLR. Set i, 56 patients, and set ii, 97 patients, were followed over 16 months. Criteria were tested against set i, and then validated using set ii. Each criterion specified a fixed critical slope of 1 dB/year and with a range of significance from Po0.001 to 0.05. The criteria were varied by altering location number, cluster arrangement, and by requiring points to show change over both 12 and 16 months. True glaucomatous change was differentiated from noise by looking for exclusive progression (EP), the detection of progression without detection of improvement. Results Set i required 1 point to have a slope of 1 dB/year and Po0.05 labelled 64% progressing and 58% improving, whereas several stricter criteria were capable of detecting EP. Two points in a perimetric nerve fibre bundle (PNFB) cluster gave optimal EP detection, labelling 8.9% progressing in set i and 7.2% progressing in set ii with a cutoff P-value of 0.026 inset i and 0.013 inset ii. Conclusion Lax PLR criteria detect large amounts of change. Validating criteria using two data sets allow selection of better criteria, capable of detecting EP. The criterion involving 2 points changing in a PNFB cluster offers the best option for exclusively detecting progression.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pointwise linear progression criteria and the detection of visual field change in a glaucoma trial

Wilkins

Fitzke²,

Khaw

2005

Eye

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“…Trabeculectomy reported had a success rates ranging between 48% and 98% according to previous literature (6,7,(19)(20)(21)(22)(23)(24)(25)(26) . The exact rate in eyes with medical therapy, however, is unknown.…”

Section: Discussionmentioning

confidence: 96%

Medical therapy versus trabeculectomy in patients with open-angle glaucoma

Motlagh

2016

Arquivos Brasileiros De Oftalmologia

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Purpose: To compare therapeutic outcomes between trabeculectomy and medical therapy in patients with open-angle glaucoma. Methods: In the present retrospective comparative study, the medical charts of 284 patients (eyes) newly diagnosed with open-angle glaucoma who had received conventional medications (n=188) or undergone fornix-based trabeculectomy (n=96) at a teaching eye hospital were reviewed. Results: At a mean follow-up of 6.6 years, post-treatment changes in intraocular pressure (IOP), visual field (VF), best spectacle-corrected visual acuity (BSCVA), and number of required drugs were significantly more favorable in the surgical group (P<0.001 for all comparisons). However, the frequency of clinically desirable IOP (≤21 mmHg) at the endpoint was comparable between the surgical and medical groups (87.2% vs. 82.3%; P=0.26). The rate of conversion to surgical therapy was 34% in the medical group. A greater baseline requirement for anti-glaucoma drugs (two or more) was the only independent predictor of treatment failure in the present study. Conclusions: Although more severe cases naturally receive trabeculectomy, the surgical approach had greater efficacy than conventional medical therapy in patients with open-angle glaucoma. An initial requirement for two or more anti-glaucoma drugs may predict failure of medical therapy.

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“…Later research showed that patients on topical medication had better quality of life compared to those who underwent trabeculectomy although trabeculectomy was more efficient in lowering the IOP [7]. The introduction of newer and more potent drops as well as further research that showed the failure of trabeculectomy over time, limited the initial enthusiasm of the surgical approach as the initial management of glaucoma [8,9]. This led to a decrease in the number of trabeculectomies performed every year in the developed countries from mid 1990's [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%