Outcome of Trabeculectomy in Early Primary Open Angle Glaucoma in Respect of Retinal Nerve Fiber Layer Thickness and Optic Nerve Head Parameters

Abstract

Introduction: Glaucoma is the group of acute and chronic multifactorial condition where lowering IOP is the mainstay of the treatment in the patients, but despite of all effort progression of disease is inevitable. The prevalence of primary open angle glaucoma (POAG) in India is 1.62% and increasing with age, where 98.5% were not even aware of the disease. In our study, we assessed the outcome of trabeculectomy using retinal nerve fiber layer (RNFL) thickness measurements and clinical parameters. Material and Method: Twenty seven patients of primary open angle glaucoma undergoing trabeculectomy were included. Ophthalmological examinations including best corrected visual acuity, pupils and anterior segment evaluation, intraocular pressure, fundus and optic disc examination, perimetry and optic coherence tomography were performed preoperatively and 1 week, 1 month and 3 months postoperatively in each and every subject. Results: With mean age of 57.9 years, total of 18 male and 9 female patients were recruited. IOP was decreased by 43.85% from baseline but best corrected visual acuity was increased marginally after 3 months postoperatively. Optic nerve head parameters were improved significantly. Visual Field analysis showed that mean sensitivity and mean deviation were improved from 8.73±4.5493 and 19.044±4.6111 preoperatively to 9.859±5.5606 and 17.926±5.4928 dB postoperatively, respectively. Conclusion: Our data suggested that in early POAG, trabeculectomy provides good IOP control and clinical outcome with little complication rate under experienced hands.