TY - JOUR
T1 - Glaucoma Surgery Decreases the Rates of Localized and Global Visual Field Progression
AU - Folgar, Francisco A.
AU - de Moraes, Carlos Gustavo V.
AU - Prata, Tiago S.
AU - Teng, Christopher C.
AU - Tello, Celso
AU - Ritch, Robert
AU - Liebmann, Jeffrey M.
N1 - Funding Information:
Supported by The Ephraim and Catherine Gildor Research Fund, New York, New York. Dr Liebmann has been a consultant for Alcon Laboratories, Allergan, Inc, Diopsys Corporation, Optovue, Inc, Pfizer Ophthalmics, and Topcon Medical Systems, Inc, and has received financial support from Carl Zeiss Meditec, Heidelberg Engineering, Inc, and Optovue, Inc. Dr Ritch has been a consultant for Alcon Laboratories, Allergan, Inc, Merck, and Pfizer Ophthalmics and has patent interest with Ocular Instruments. Dr Tello has been a consultant for Diopsys Corporation and has been a lecturer for Alcon Laboratories and Allergan, Inc. Involved in design and conduct of study (C.G.V.D.M., T.S.P., C.C.T., R.R., J.M.L.); Collection of data (F.A.F., C.G.V.D.M., T.S.P., C.C.T.); Analysis and interpretation of data (F.A.F., C.G.V.D.M., T.S.P., C.C.T., J.M.L.); Preparation of manuscript (F.A.F., C.G.V.D.M., C.C.T., J.M.L.); and Review and approval of manuscript (C.G.V.D.M., C.C.T., C.T., R.R., J.M.L.). The study was conducted in compliance with the Declaration of Helsinki, the Health Insurance Portability and Accountability Act, and the Institutional Review Board of the New York Eye and Ear Infirmary.
PY - 2010/2/1
Y1 - 2010/2/1
N2 - Purpose: Incisional glaucoma surgical procedures produce greater intraocular pressure (IOP) reduction and less IOP variability than medical treatment. We sought to determine the efficacy of glaucoma surgery in decreasing localized and global rates of visual field (VF) progression. Design: Retrospective, interventional case series. Methods: Subjects in the New York Glaucoma Progression Study with glaucomatous optic neuropathy, repeatable VF loss, and 10 or more Swedish interactive threshold algorithm standard VF examinations were assessed for eligibility. Patients who underwent successful glaucoma surgery (not requiring further surgical intervention and IOP < 18 mm Hg) in either eye and who were followed up for at least 2 years before and after surgery were enrolled. Automated pointwise linear regression analysis was used to calculate global and localized rates of progression before and after surgery. Eyes with other ocular conditions likely to affect the VF and an insufficient number of VF to create a slope before and after surgery were excluded. Comparisons were performed within the same eyes before and after surgery (Student paired t test). Results: We enrolled 28 eyes of 28 patients (mean age, 61.2 ± 14.5 years). The mean number ± standard deviation of VF was 13.4 ± 2.3, spanning 7.1 ± 1.2 years (range, 4 to 9 years). Mean IOP ± standard deviation decreased from 19.0 ± 3.9 mm Hg before surgery to 11.3 ± 3.7 mm Hg after surgery (40% reduction; P < .01). Mean global progression rates decreased from -1.48 ± 1.4 dB/year before surgery to -0.43 ± 0.8 dB/year after surgery (70% reduction; P = .01). Twelve eyes (42.8%) had at least 1 significantly progressing point before surgery, whereas only 2 (7.1%) had at least 1 progressing point after surgery. Each 1 mm Hg of IOP reduction after surgery resulted in a 0.1 dB/year decrease in the global rate of progression. Conclusions: Successful IOP reduction after glaucoma surgery greatly reduces both the number of progressing points and the localized and general rates of VF progression.
AB - Purpose: Incisional glaucoma surgical procedures produce greater intraocular pressure (IOP) reduction and less IOP variability than medical treatment. We sought to determine the efficacy of glaucoma surgery in decreasing localized and global rates of visual field (VF) progression. Design: Retrospective, interventional case series. Methods: Subjects in the New York Glaucoma Progression Study with glaucomatous optic neuropathy, repeatable VF loss, and 10 or more Swedish interactive threshold algorithm standard VF examinations were assessed for eligibility. Patients who underwent successful glaucoma surgery (not requiring further surgical intervention and IOP < 18 mm Hg) in either eye and who were followed up for at least 2 years before and after surgery were enrolled. Automated pointwise linear regression analysis was used to calculate global and localized rates of progression before and after surgery. Eyes with other ocular conditions likely to affect the VF and an insufficient number of VF to create a slope before and after surgery were excluded. Comparisons were performed within the same eyes before and after surgery (Student paired t test). Results: We enrolled 28 eyes of 28 patients (mean age, 61.2 ± 14.5 years). The mean number ± standard deviation of VF was 13.4 ± 2.3, spanning 7.1 ± 1.2 years (range, 4 to 9 years). Mean IOP ± standard deviation decreased from 19.0 ± 3.9 mm Hg before surgery to 11.3 ± 3.7 mm Hg after surgery (40% reduction; P < .01). Mean global progression rates decreased from -1.48 ± 1.4 dB/year before surgery to -0.43 ± 0.8 dB/year after surgery (70% reduction; P = .01). Twelve eyes (42.8%) had at least 1 significantly progressing point before surgery, whereas only 2 (7.1%) had at least 1 progressing point after surgery. Each 1 mm Hg of IOP reduction after surgery resulted in a 0.1 dB/year decrease in the global rate of progression. Conclusions: Successful IOP reduction after glaucoma surgery greatly reduces both the number of progressing points and the localized and general rates of VF progression.
UR - https://www.scopus.com/pages/publications/73549119525
U2 - 10.1016/j.ajo.2009.09.010
DO - 10.1016/j.ajo.2009.09.010
M3 - Article
AN - SCOPUS:73549119525
SN - 0002-9394
VL - 149
SP - 258-264.e2
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 2
ER -