COPENHAGEN, Denmark — After trabeculectomy, patients continue to experience vision loss, demonstrating that the visual results of filtration surgery are not always satisfactory, a specialist said here.
"Visual results are less than optimum. And you might agree with me — that's a big, big understatement," Tarek Shaarawy, MD, MSc, said at the European Glaucoma Society meeting.
Patients often undergo glaucoma therapy only once they are nearly blind with advanced stages of the disease, which does not allow for better visual recovery that could occur in earlier stages, Shaarawy said.
"The paradox is that when we operate late, we increase the rate of complications, we lose eyes, and we end up with blindness, which scares the hell out of us so we do not operate early. We continue to operate late, and this is the vicious circle that has to be addressed and has to be addressed soon because basically we have to break free," Shaarawy said.
While trabeculectomy reduces IOP, especially in advanced cases, it has a long list of associated complications, many of which are vision-threatening.
Shaarawy cited numerous studies showing visual loss. The National Survey of Trabeculectomy in the U.K. found an 18.8% rate of visual loss at 1 year, and the TVT study found a loss of two lines after 1 year in 33% of patients undergoing trabeculectomy. A study published in the Journal of Glaucoma found that more than half of patients who underwent trabeculectomy lost two or more Snellen lines.
- Disclosure: Shaarawy has no relevant financial disclosures.