Abstract

CASIRAGHI, JF; MOUSSALLI, MA  and  LAVENA, PI. Perimetric evolution after surgery in advanced  glaucoma. Arch Soc Esp Oftalmol [online]. 2003, vol.78, n.9, pp.507-512. ISSN 0365-6691.

Purpose: To determine the perimetric evolution in patients with advanced glaucomatous damage after glaucoma surgery, trabeculectomy or phacotrabeculectomy between 1996 and 2001. Material and Methods: A retrospective review of the charts of 1,539 patients was performed. Mean follow-up was 23.14 months (SD 15.17 months). A retrospective, observational, longitudinal, comparative and pattern relation of the visual field, before and after surgery, regarding mean defect (MD) and loss variance (LV) was also performed. We included 102 eyes (79 patients), who presented advanced glaucomatous damage before surgery, who had undergone automated static perimetry. Results: The difference between MD before and after surgery was statistically significant (p=0.001), whereas the difference between LV before and after surgery was not statistically significant (p =0.2421). Mean MD before phacotrabeculectomy was 16.90 dB and after surgery was 14 dB (p = 0.005), while mean LV before surgery was 43.5 dB and after surgery was 44.5 dB (p = 0.835). Mean MD before trabeculectomy was 17.91 dB and after surgery was 15.93 dB (p = 0.004), while mean LV before surgery was 48.05 dB and after surgery 44.66 dB (p=0.166). Conclusions: These results support the hypothesis that filtering surgery (trabeculectomy) or combined surgery (phacotrabeculectomy) in patients with advanced glaucoma are associated with a significant improvement of the mean defect in standard automated perimetry without a significant change of LV defect.

Keywords : Perimetric evolution; advanced glaucoma; trabeculectomy; phacotrabeculectomy; intraocular pressure.