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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-04-2010 | Retinal Disorders

Improved retinal function after trabeculectomy in glaucoma patients

Authors: Elisabeth Wittström, Patrik Schatz, Monica Lövestam-Adrian, Vesna Ponjavic, Anders Bergström, Sten Andréasson

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 4/2010

Abstract

Purpose

To investigate retinal function after reduction of intraocular pressure (IOP) by filtration surgery in patients with medically uncontrolled glaucoma.

Methods

Eleven patients (11 eyes) with medically uncontrolled glaucoma underwent trabeculectomy. Clinical investigation, visual field (testing with standard automated perimetry (SAP–Humphrey), optical coherence tomography (OCT), full-field electroretinography (full-field ERG) and multifocal electroretinography (mfERG) were performed preoperatively as well as 2 and 6 months after surgery.

Design

Interventional prospective, consecutive case series.

Results

No significant reduction was seen in mean log MAR visual acuity 2 or 6 months after filtration surgery. The mean preoperative intraocular pressure of 27.1 (±6.2) mmHg decreased to 19.0(±6.1) mmHg 2 months after surgery and to 17.1 (± 3.4) mmHg 6 months after surgery (both p = 0.001). The reduction in IOP significantly decreased the number of anti-glaucoma agents used, from 3.7 ± 1.6 at baseline to 0.8 ± 0.9 2 months after surgery and to 1.3 ± 1.2 6 months after surgery (p = 0.004 and p = 0.008 respectively). The results of SAP, OCT and full-field ERG did not show any significant difference between pre- and postoperative values at any point in time. No significant improvement was found with regard to the first positive peak (P₁) amplitudes in the macular retina (area 1) or in the perimacular retina/periphery (area 2) when measured with mfERG 2 months after surgery. The mfERG examinations revealed significantly improved P₁ amplitudes 6 months after surgery in both area 1 and area 2, compared with the preoperative values (p = 0.042 and p = 0.014 respectively). The implicit time of P₁ decreased significantly 6 months after surgery in area 2 compared with the preoperative values (p = 0.023).

Conclusion

A significant lowering of IOP seems to improve the function of the central retina, as demonstrated by increased amplitudes and reduced implicit times assessed with mfERG.

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Title: Improved retinal function after trabeculectomy in glaucoma patients
Authors: Elisabeth Wittström
Patrik Schatz
Monica Lövestam-Adrian
Vesna Ponjavic
Anders Bergström
Sten Andréasson
Publication date: 01-04-2010
Publisher: Springer-Verlag
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 4/2010
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-009-1220-5

At a glance: The STEP trials

Springer Medicine

Improved retinal function after trabeculectomy in glaucoma patients

Abstract

Purpose

Methods

Design

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Design

Results

Conclusion

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