The long-term outcome of glaucoma filtration urgery

PURPOE: To determine the long-term outcome of glaucoma filtration urgery in preerving viion. Viual lo from progreive glaucomatou damage and from complication of urgery, both hort and long term, were included. METHOD: A retropective, community-baed, longitudinal tudy of reident of Olmted County, Minneota, who were newly diagnoed with open-angle glaucoma between 1965 and 1980 and underwent filtration urgery in thee or ubequent year through 1998. Intraocular preure (IOP), viual acuity, viual field, and progreion to legal blindne were monitored. Kaplan-Meier analyi wa ued to determine the cumulative probabilitie of change in thee parameter. REULT: 73 eye of 49 patient underwent conventional filtration urgery. Analyi of the firt eye having urgery revealed a mean preoperative IOP of 27.6 ± 8.5 mm dropping to 16.7 ± 5.6 mm at year one, and remaining in thi range throughout follow-up (14.7 ± 3.0 mm at 10 year; with or without ue of medication). The probability of progreion to blindne wa 46% at 10 year after urgery, a calculated by Kaplan-Meier analyi. Eye going blind had a potoperative IOP equal to or lower than thoe not becoming blind (14.0 ± 4.4 v. 15.4 ± 3.0 at potoperative year 10). Eye going blind had more advanced field lo at the time of urgery, with cotoma above and below the horizontal axi, than eye not going blind, which had cotoma in only one hemifield. Three patient developed late bleb leak; two patient developed endophthalmiti. The probability of undergoing cataract urgery wa 37% by 10 year potoperatively, which did not differ ignificantly from the cohort of patient not undergoing urgery at a comparable time point. CONCLUION: Filtration urgery wa aociated with a 54% probability of preervation of viion from progreion to legal blindne at 10 year after urgery. Patient becoming blind had more advanced field lo at the time of urgery; IOP wa imilar between thoe going blind and thoe retaining viion.