Kosuke Nakajima1,2, Rei Sakata3,4, Koji Ueda2, Asahi Fujita2,5, Takashi Fujishiro2,6, Megumi Honjo2,6, Shiroaki Shirato6, Makoto Aihara2,6. 1. Department of Ophthalmology, Showa General Hospital, Tokyo, Japan. 2. Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan. 3. Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan. reisakata-tky@umin.ac.jp. 4. Yotsuya Shirato Eye Clinic, Tokyo, Japan. reisakata-tky@umin.ac.jp. 5. Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan. 6. Yotsuya Shirato Eye Clinic, Tokyo, Japan.
Abstract
PURPOSE: To investigate how the central visual field would be changed after fornix-based trabeculectomy with mitomycin C in Japanese normal-tension glaucoma (NTG) patients monitored for more than 10 years including before surgery. METHODS: This is a retrospective cohort study. We identified twenty-eight eyes of 28 NTG cases regularly monitored for more than 5 years and examined static visual field (VF) tests for more than five times before and after fornix-based trabeculectomy (including combined surgery). Based on preoperative data for 6.3 years, we evaluated postoperative changes for 6.0 years in 10-2 VF and 30-2 VF. RESULTS: Six patients were male and 22 females, the mean age was 57.9 years, and the mean deviation was - 13.7 decibels. After surgery, mean IOP decreased from 13.9 to 9.0 mmHg (P ≤ 0.01), and medication score also did. The rate of 10-2 VF deterioration was significantly suppressed from - 1.0 dB/year preoperatively to - 0.4 dB/year postoperatively (P ≤ 0.01). And when 30-2 VF was divided into six relevant sectors, the rate of deterioration at cecocentral and arcuate areas of the superior hemifield was suppressed postoperatively (P ≤ 0.01 and P = 0.042, respectively). CONCLUSION: Based on long-term preoperative data, a significant positive change in 10-2 VF was observed after fornix-based trabeculectomy with mitomycin C in Japanese NTG patients with a mean IOP of 13.9 mmHg. Central vision could be expected to be maintained for NTG patients even if its preoperative IOP is low after successful trabeculectomy.
PURPOSE: To investigate how the central visual field would be changed after fornix-based trabeculectomy with mitomycin C in Japanese normal-tension glaucoma (NTG) patients monitored for more than 10 years including before surgery. METHODS: This is a retrospective cohort study. We identified twenty-eight eyes of 28 NTG cases regularly monitored for more than 5 years and examined static visual field (VF) tests for more than five times before and after fornix-based trabeculectomy (including combined surgery). Based on preoperative data for 6.3 years, we evaluated postoperative changes for 6.0 years in 10-2 VF and 30-2 VF. RESULTS: Six patients were male and 22 females, the mean age was 57.9 years, and the mean deviation was - 13.7 decibels. After surgery, mean IOP decreased from 13.9 to 9.0 mmHg (P ≤ 0.01), and medication score also did. The rate of 10-2 VF deterioration was significantly suppressed from - 1.0 dB/year preoperatively to - 0.4 dB/year postoperatively (P ≤ 0.01). And when 30-2 VF was divided into six relevant sectors, the rate of deterioration at cecocentral and arcuate areas of the superior hemifield was suppressed postoperatively (P ≤ 0.01 and P = 0.042, respectively). CONCLUSION: Based on long-term preoperative data, a significant positive change in 10-2 VF was observed after fornix-based trabeculectomy with mitomycin C in Japanese NTG patients with a mean IOP of 13.9 mmHg. Central vision could be expected to be maintained for NTG patients even if its preoperative IOP is low after successful trabeculectomy.
Entities:
Keywords:
Central visual field; Fornix-based; Japanese; Normal-tension glaucoma; Trabeculectomy
Authors: Paul J Ernest; Jan S Schouten; Henny J Beckers; Fred Hendrikse; Martin H Prins; Carroll A Webers Journal: Ophthalmology Date: 2012-12-01 Impact factor: 12.079
Authors: Carlos Gustavo De Moraes; Jeffrey M Liebmann; David S Greenfield; Stuart K Gardiner; Robert Ritch; Theodore Krupin Journal: Am J Ophthalmol Date: 2012-07-25 Impact factor: 5.258