I Can See Clearly Now

Glaucoma patients undergoing trabeculectomy surgery show good long-term outcomes

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A surgical procedure that relieves inner eye pressure for glaucoma patients remained successful for a majority of patients twenty years after the surgery according to a new study.

A trabeculectomy is a surgery that involves removing a portion of the inner eye to relieve the symptoms of many forms of glaucoma and is the most common form of glaucoma surgery.

"Trabeculectomy procedures usually work to relieve glaucoma."

A study of patients who had the procedure in England twenty years ago reveled that only 15 percent had become blind, and almost 90 percent who continued to use topical medication were doing well.

Lead author John Landers, Ph.D, of the Department of Ophthalmology at Addenbrooke's Hospital in Cambridge, United Kingdom, and fellow researchers looked at the medical records of 234 patients who had undergone 330 trabeculectomies between January 1988 and December 1990.

They followed up with the patients and defined their status as a complete success if the patients continued to have low intraocular pressure without needing to use additional medication. A "qualified success" labeled those who maintained low inner eye pressure while continuing to use a topical medication.

Landers and his team found that 57 percent of the patients were a complete success, and 88 percent were a qualified success. They therefore concluded that trabeculectomy procedures are a long-term solution to relieving the inner eye pressure that causes glaucoma.

“Surgical trabeculectomy remains an important tool in the management of advanced glaucoma, and this study confirms the long term success that can be achieved with well performed surgery," said Dr. Christopher Quinn, an optometrist from Omni Eye Associates who was not involved in the study.

"Often trabeculectomy is the best method to achieve sustained low eye pressure, which in turn, helps even patients with advanced glaucoma from going blind from the disease,” Quinn said.

The procedure failures were more likely to occur in younger patients or patients who had glaucoma as a result of uveitis, an inflammation of the middle layer of the eye.

Those most likely to be in the 15 percent who became blind had pseudoexfoliation glaucoma or had aphakia, a loss of the lens of the eye that often results from surgery to remove cataracts.

The researchers noted that a patient's age, use of topical medication prior to surgery and his or her type and severity of glaucoma will also all play a factor in the success of the procedure.

The study appears in the December issue of the journal Ophthalmology, and the authors noted no financial conflicts of interest associated with this research.

Reviewed by: 
Review Date: 
January 8, 2012
Last Updated:
January 14, 2012