Surgical management of primary open-angle glaucoma in Central China: A 6-year retrospective cohort study

Through several cases of the new rural cooperative medical care, in which patients take another's place by counterfeiting and uninsured patients are hospitalized through fraudulent use of the identity of insured patients, the author analyzes the vulnerabilities in the new rural cooperative medical management from the perspective of medical record management, such as the lack of a perfect information system for the new rural cooperative medical system (NRCMS), lack of a second-generation ID card identification system in the hospital admission office, weak concept awareness among physicians, inadequate supervision of NRCMS by the supervision department and so on. To solve the above problems, there is a need to accelerate the development and utilization of the new rural cooperative medical information system, strengthen the degree of the hospital's management of the admission office workers, enforce the use of second-generation ID card identification system and add the fingerprint recognition functio...

Rural in medical care one of most important problems in China since it relates to the health care of over half of China's population. Under such severe circumstances, China's government started to bring new rural cooperative medical care system into effect since the beginning of 21st century. It had been six crucial years until 2003 for The New Rural Cooperative Medical System (NRCMS) , which has achieved good results. But the system has been encountered lots of problems and need to be continuously improved as an innovative one.This article analyzes the present situation of the medical security system in the China, which consists of two chapters. The first is to explain the medical system of China in terms of setup, development, promotion and decline from historical point of view. The second is to investigate the implementation and problems of the new rural cooperatives medical system. As most of the farmer does not trust the NRCMS, and safeguard level it seems difficult for the cooperative medical treatment has difficulties to adapt various medical safeguard demands.

BackgroundThis is the first comprehensive comparison between gonioscopy-assisted transluminal trabeculotomy (GATT) and GATT combined with ab interno canaloplasty (ABiC) in patients with OAG.PurposeThe purpose of this study was to compare the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) combined with ab interno canaloplasty (ABiC) with those of GATT alone in patients with open-angle glaucoma (OAG).DesignThis was a retrospective, comparative case series.ParticipantsPatients with primary open angle glaucoma who underwent GATT (27 eyes in Group 1) or GATT + ABiC (26 eyes in Group 2) were included.MethodsOutcomes including intraocular pressure (IOP), glaucoma medications, and surgical complications were analyzed.Main outcome measuresSurgical success was defined in terms of IOP and medication use as follows: (1) a preoperative IOP > 21 mmHg and a postoperative IOP ≤ 21 mmHg with at least a 20% reduction from baseline with (qualified success) or without (complete success) glaucoma medications or (2) a preoperative IOP < 21 mmHg while taking 3 or more glaucoma medications and a postoperative IOP ≤ 21 mmHg with a reduction of more than two medications (qualified success) or with no medications (complete success).ResultsAt 12 months, the mean IOP was 14.8 ± 2.2 mmHg in Group 1 and 16.6 ± 2.3 mmHg in Group 2 (p = 0.008). The number of medications was 0.6 ± 1.0 in Group 1 and 0.9 ± 1.3 in Group 2 (p = 0.334). At 24 months, the mean IOP was 15.3 ± 2.0 mmHg in Group 1 and 15.5 ± 2.4 mmHg in Group 2 (p = 0.676). The number of medications was 0.5 ± 0.9 in Group 1 and 0.9 ± 1.1 in Group 2 (p = 0.197). The complete success rates were 63.0% in Group 1 and 50.0% in Group 2 (p = 0.16), and the qualified success rates were 81.5% in Group 1 and 76.9% in Group 2 (p = 0.51).ConclusionThe GATT procedure, with or without ABiC, is safe and effective in decreasing the IOP and the number of antiglaucoma medications used.

The purpose of the study was to evaluate the safety and efficacy of the iStent Trabecular Micro-Bypass stent in pseudophakic patients with open-angle glaucoma. Retrospective, consecutive case series from October 2012 to May 2015 with no exclusion criteria. The series comprised 42 pseudophakic eyes with open-angle glaucoma that were implanted with 1 iStent. Data were collected preoperatively, and postoperative data were collected at 1 day, 1 week, 1, 3 and 6 months, 1 year, 18 months and 2 years. Data included intraocular pressure (IOP), number of glaucoma medications, the incidence of postoperative IOP pressure spikes ≥15 mm Hg at any timepoint, and the need for additional surgery. The mean preoperative IOP was 20.26±6.00 mm Hg. At 1 year postoperatively, the mean IOP was 16.34±3.78 mm Hg (P<0.01). At 2 years postoperatively, the mean IOP was 13.62±4.55 (P<0.01). The mean number of glaucoma medications was 1.95±1.01 preoperative and 1.69±1.28 (P>0.05) at 1 year postoperatively. Postoperatively, 3 eyes (7%) experienced an IOP increase of 15 mm Hg above their baseline IOP that responded to topical therapy. In total, 96% of patients with an IOP≥19 mm Hg achieved a reduction in IOP at their last collected follow-up. The insertion of the iStent Trabecular Micro-Bypass stent effectively lowers IOP in pseudophakic patients with open-angle glaucoma. Although medication use was not significantly reduced postoperatively at 1 year, 80% of patients either experienced a reduction or no change in medication use. The safety profile appears favorable with a low rate of IOP spikes and only 1 patient requiring additional surgery.

The iStent inject W implanted during phacoemulsification effectively reduces IOP. The purpose of this study was to evaluate the efficacy and safety of iStent inject W combined with phacoemulsification in patients with controlled open angle glaucoma undergoing cataract surgery. We conducted a retrospective, bicentric study of patients with controlled chronic open angle glaucoma who underwent phacoemulsification combined with the injection of 2 iStent inject Ws. Patient characteristics, including intraocular pressure (IOP) and the number of glaucoma medications, were evaluated preoperatively and 1 week, 1 month, and 6 months postoperatively. The primary end point was IOP reduction, and the secondary end point was the reduction in the number of glaucoma medications. In this study, 85 eyes were included. The majority of patients had primary open angle glaucoma (85% of eyes). Preoperative mean IOP was 16.1±2.0mmHg with a mean of 2.3±0.5 glaucoma medications. At 1 week postoperatively, the mean IOP was 16.7±3.1mmHg with a mean of 2.0±0.7 hypotensive medications. At 1 and 6 months, the mean IOP was 14.2±2.1 and 13.0±1.5mmHg, with a mean of 2.0±0.6 and 1.8±0.5 glaucoma medications, respectively. The percentage IOP reduction at 1 and 6 months was 11.6% ( P =0.001) and 19.3% ( P <0.0001), respectively. Regarding glaucoma medications, at 1 and 6 months, the reduction in the number of medications was 12.9% ( P =0.025) and 22.4% ( P =0.003), respectively. The most frequent significant postoperative adverse events were corneal edema in 7%, IOP spikes in 6%, and hyphema in 6% of eyes, which resolved spontaneously. The iStent inject W implanted during phacoemulsification effectively reduces IOP and the number of glaucoma medications needed at 6 months of follow-up, with a favorable safety profile in patients with controlled open angle glaucoma.

BackgroundTo evaluate the safety and efficacy of gonioscopy-assisted transluminal trabeculotomy (GATT) in treating patients with open-angle glaucoma (OAG) who had failed prior incisional glaucoma surgery.MethodsA consecutive case series of OAG patients aged ≥ 18 who underwent GATT with previous failed glaucoma incision surgery was retrospectively analyzed. Main outcome measures included intraocular pressure (IOP), the number of glaucoma medications, surgical success rate, and occurrence of complications. Success was defined as an IOP of ≤ 21 mmHg and a reduction of IOP by 20% or more from baseline with (qualified success) or without (complete success) glaucoma medications. For eyes with preoperative IOP of < 21 mmHg on 3 or 4 glaucoma medications, postoperative IOP of ≤ 18 mmHg without any glaucoma medications was also defined as complete success.ResultsForty-four eyes of 35 patients (21 with juvenile-onset open-angle glaucoma and 14 with adult-onset primary open-angle glaucoma) with a median age of 38 years were included in this study. The proportion of eyes with 1 prior incisional glaucoma surgery was 79.5%, and the others had 2 prior surgeries. IOP decreased from 27.4 ± 8.8 mm Hg on 3.6 ± 0.7 medications preoperatively to 15.3 ± 2.7 mm Hg on 0.5 ± 0.9 medications at the 24-month visit (P < 0.001). The mean IOP and the number of glaucoma medications at each follow-up visit were lower than the baseline (all P < 0.001). At 24 months postoperatively, 82.1% of the eyes had IOP ≤ 18 mmHg (versus 15.9% preoperatively, P < 0.001), 56.4% reached IOP ≤ 15 mmHg (versus 4.6% preoperatively, P < 0.001), and 15.4% achieved IOP ≤ 12 mmHg (compared to none preoperatively, P = 0.009). While 95.5% of eyes took 3 or more medications preoperatively, 66.7% did not take glaucoma medication 24 months after GATT. Thirty-four (77.3%) eyes achieved IOP reduction greater than 20% on fewer medications. The complete and qualified success rates were 60.9% and 84.1%, respectively. No vision-threatening complications occurred.ConclusionsGATT was safe and effective in treating refractory OAG patients who failed prior incisional glaucoma surgery.

Background: Management of refractory glaucoma is difficult and this study aims to find the success rate of glaucoma drainage device (GDD) among such advanced glaucoma patients. Materials and Methods: This study was done in 37 patients who underwent GDD implantation, either Ahmed glaucoma valve (AGV) (21 cases) or Aurolab aqueous drainage implant (AADI) (16 cases) for management of refractory glaucoma. Surgery was performed by a single surgeon, over a duration of 1 year; outcome measures were assessed sequentially over 1 year and after that medical records from GDD implanted patients were analyzed. The surgical method was glaucoma valve implantation with patch less scleral graft with “tunnel and track” technique. Main outcome measures included intraocular pressure (IOP), visual acuity (V/A) before and after surgery, complications, need for repeat procedure, comparison between AGV and AADI and success rate. Surgical success was defined as IOP between 5 and 22 mmHg with or without antiglaucoma medications or need for further IOP lowering surgeries or at least V/A of perception of light. In all visits, IOP was measured with Goldmann/Perkins applanation tonometer. Results: The most prevalent cause of refractory glaucoma in the study group was neovascular glaucoma (NVG) in 51.35% cases. Mean IOP before surgery among 37 patients was 43.05 ± 8.14 mmHg and after 1 year follow-up, mean IOP was found to be 17.02 ± 6.84 mmHg. Repeat procedure was done in 37.83% cases and it included hyphema wash in 27% and tube-repositioning in 2.7%. Improvement of vision was not significant in the study group. Common complications encountered were early postoperative hyphema (27%), hypotony (10.8%), hypertensive phase (18.91%), tube block (2.7%), and valve dislocation (2.7%). Success was achieved in 72.97% cases. Among the two types of valve, AADI cases had more than 5 mm lower IOP values at 1 year compared to AGV. Conclusion: GDD implantation is a very useful method to reduce IOP in refractory glaucoma. As success was achieved in over 70% cases, this surgery can be eye saving in conditions where prognosis is very poor and traditional methods are destined to fail. This surgery can be particularly suitable for NVG and postretinal surgery glaucoma as well.

In 2003, the Chinese rural health care system underwent substantial reform with the introduction of the New Rural Cooperative Medical System (NRCMS). In order to identify factors associated with health services utilization among rural residents enrolled in NRCMS in Hainan Province, China, we conducted a cross-sectional household survey in rural villages from six randomly selected Han and ethnic minority cities or counties in Hainan in 2009 to identify factors associated with health service utilization among rural residents enrolled in the NRCMS in Hainan Province, China. Logistic regressions were used to identify factors associated with utilization of outpatient visits and inpatient visits. Among the total 871 subjects of observations, about 45% had at least one outpatient visit in the 12 months prior to the survey and 13% had at least one inpatient visit during that period. Outpatient visits were directly associated with location of residence (Han-concentrated region vs. ethnic minority-concentrated region), education level, presence of chronic disease, health insurance plan and satisfaction with quality of care in NRCMS network providers. Similarly, inpatient visitation was significantly associated with education level, presence of chronic disease and satisfaction with quality of care in NRCMS network providers. The use of both outpatient and inpatient services was significantly associated with location of residence, education level, presence of chronic disease, health insurance plan and satisfaction with quality of care in NRCMS network providers. Evidence suggests that NRCMS was significantly associated with access to care in rural areas, especially in ethnic minority regions in Hainan, but there still exist challenges in assessing the degree of unnecessary utilization of inpatient services.

Both Xen gel Microstent implantation and Kahook Dual Blade (KDB) goniotomy are safe and effective as stand-alone procedures, but the Xen Gel Microstent was associated with more postoperative interventions and achieved higher success at a lower intraocular pressure threshold. To evaluate outcomes of stand-alone Xen Gel Microstent implantation compared with stand-alone KDB goniotomy for moderate to severe glaucoma. A retrospective, single-center, case-series analysis comparing outcomes of Xen Gel Microstent implantation and KDB goniotomy stand-alone cases in 75 eyes. Primary outcomes included intraocular pressure (IOP) reduction, glaucoma medication reduction, surgical success, and complications. Surgical success was defined using IOP<21 mm Hg and IOP<18 mm Hg thresholds, with or without glaucoma medications, and without further glaucoma surgery. Subjects were followed for at least 24 months after surgery. Mean baseline IOP was comparable between the Xen Gel Microstent and KDB goniotomy groups (23.7±8.4 and 25.9±7.9 mm Hg, respectively, P =0.32). At 24 months after surgery, the mean IOP after Xen Gel Microstent was 14.7±3.2 mm Hg (32.7% reduction from baseline, P =0.018) and KDB goniotomy was 16.7±3.2 mm Hg (40.4% reduction from baseline, P =0.049). Although the mean IOP was significantly lower during the first month after Xen Gel Microstent implantation, no difference in mean IOP was observed between the 2 treatment groups at 24 months after surgery ( P =0.416). At 24 months after surgery, the percent reduction of IOP from baseline was not significantly different between the 2 groups. The mean reduction of glaucoma medications from baseline at 24 months was 1.69 drops after Xen Gel Microstent implantation ( P =.008) and 1.67 drops after KDB goniotomy ( P =0.038). Postoperative complications were nonvision-threatening and were not significantly different between the 2 groups ( P =0.550). Interventions not included with complications were needling performed in 21 (37%) of eyes in the Xen Gel Microstent group and Nd:YAG goniopuncture in 1 (5.6%) eye after KDB goniotomy. With an IOP threshold <21 mm Hg, surgical success was not significantly different between the 2 groups ( P =0.06). At a lower IOP threshold (<18 mm Hg), surgical success was higher after Xen Gel Microstent implantation compared with KDB goniotomy ( P =0.001). Both stand-alone Xen Gel Microstent implantation and KDB goniotomy can effectively and safely reduce IOP for moderate to severe glaucoma. The Xen Gel Microstent was associated with a higher need for postoperative interventions and achieved greater success at a lower IOP threshold.

PurposeTo evaluate the safety and efficacy of the iStent trabecular microbypass stent in combination with cataract surgery in patients with open-angle glaucoma (OAG).MethodsRetrospective, consecutive case series from October 2012 to December 2015 with no exclusion criteria. The series comprised of 350 eyes with OAG and cataract. Data were collected both preoperatively and postoperatively at day 1 week 1, months 1, 3, 6, 12, 18, and 24. Data included intraocular pressure (IOP), number of glaucoma medications, visual acuity, the incidence of postoperative IOP pressure spikes of greater than ≥15 mmHg at any time point, and need for additional surgery.ResultsThe mean preoperative IOP was 19.13±6.34 mmHg. At 2 years postoperation, mean IOP was 15.17±3.53 mmHg (P<0.0001). The mean number of glaucoma medications was 1.19±1.00 preoperatively and 0.61±0.96 (P<0.0001) at 2 years postoperation. At 1 day postoperatively, 31 eyes (12.4%) experienced an IOP increase of 15 mmHg above their baseline IOP that responded to topical therapy. Two patients required additional tube shunt surgery.ConclusionThe insertion of the iStent trabecular microbypass stent in combination with cataract surgery effectively lowers IOP in OAG patients. The magnitude of IOP reduction was more significant in patients with higher preoperative pressure. Medication use was also significantly reduced postoperatively. The safety profile appears favorable with a low rate of IOP spikes and only two eyes (<1%) requiring additional surgery.

This study aimed to compare the 1-year postoperative phacoemulsification-trabeculectomy (P-Trab) and phacoemulsification-ExPRESS® (P-200 model) miniature shunt (P-ExPRESS) combined surgeries. This retrospective, comparative clinical study investigated 41 eyes of 41 patients diagnosed with open-angle glaucoma and cataract. Of these, 21 eyes underwent P-Trab surgery and 20 eyes underwent P-ExPRESS surgery. The 1-year follow-up results, including intraocular pressure (IOP), visual acuity (VA), medications, and complications, were reviewed and compared. A 5 ≤ IOP ≤ 18mmHg or 30% reduction from baseline was defined as Qualified Success (QS-1), and target IOP without medication was defined as Complete Success (CS-1). A 5 ≤ IOP ≤ 15mmHg or 40% reduction from baseline was defined as Qualified Success (QS-2), and target IOP without medication was defined as Complete Success (CS-2). The mean follow-up time was 16months (12-26months). Results after the twelfth month for P-Trab versus P-ExPRESS are: CS-1: 42.8% versus 60.0% (P = 0.354); QS-1: 86.7% versus 95% (P = 0.606); CS-2:33.3% versus 40% (P = 0.751); QS-2: 66.6% versus 75% (P = 0.733). Kaplan-Meier survival analysis was not statistically significant between two groups for both QS-1, CS-1 and QS-2, CS-2 (P = 0.329 vs P = 0.365, P = 0.765 vs P = 0.789, respectively). Pre-op mean IOP was: 33.19 ± 8.7 versus 34.55 ± 11.3mmHg; post-op mean IOP was: 15.19 ± 3.07 versus 15.30 ± 3.32mmHg (P = 0.913); pre-op mean VA was: 1.17 ± 1.04 versus 1.15 ± 1.07 logMAR; and post-op mean VA was: 0.61 ± 0.80 versus 0.66 ± 0.99 logMAR (P = 0.869). The pre-op mean number of antiglaucomatous medications was 3.76 ± 0.53 versus 3.30 ± 1.45, and the post-op results were 1.52 ± 1.53 versus 0.85 ± 1.26 (P = 0.135). Comparing the pre-op and post-op values, both types of surgeries were equally effective (P = 0.00). Surgical failure was 14.2% (3/21) versus 5% (1/20), and the incidence ratios of significant complications were: 47% (10/21) versus 10% (2/20) and P-Trab versus P-ExPRESS, respectively (P = 0.015). The 1-year postoperative results suggest that P-ExPRESS is as effective as P-Trab, with fewer complications.

AimThis study aimed to report the preliminary surgical outcomes of a new minimally invasive glaucoma surgery (MIGS), namely trabeculotome tunneling trabeculoplasty (3T) in primary open-angle glaucoma (POAG).MethodsThis retrospective observational study with prospective follow-up included POAG patients who underwent 3T surgery at Chengdu First People’s Hospital between December 2022 and June 2024. Postoperative follow-up was conducted at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months. Evaluations included intraocular pressure (IOP), number of medications, surgical success rate, and postoperative complications.ResultsBaseline mean IOP was 23.06 ± 0.72 mmHg with a median of 3 (interquartile range, IQR: 2–3) medications. Postoperative IOP significantly decreased at all follow-up points except at 1 week (p < 0.05). At 12 months, the mean IOP was 16.22 ± 0.76 mmHg with a median of 0 (IQR: 0–1) medications. Complete surgical success rates were 80.0% at 6 months and 79.8% at 12 months. Early postoperative complications included IOP spikes in 34.9% and clinically significant hyphema in 6.3% (all grade 1). Cyclodialysis was rare (1.1%), and no severe adverse events were reported.Conclusion3T appears to be a safe and effective surgical option for POAG, providing sustained IOP reduction and medication burden relief with a low incidence of postoperative complications. Larger, controlled studies with longer follow-up are warranted to further validate these findings.

The aim of the study was to assess the midterm efficacy and safety of the iStent glaucoma device in patients with open-angle glaucoma (OAG). We conducted a retrospective case series of all patients implanted with iStent inject® in OAG. Primary outcomes included intraocular pressure (IOP) and the reduction of antiglaucoma medications. Safety outcomes comprised adverse complications, additional surgeries, and postoperative best-corrected visual acuity (BCVA). Eight eyes from eight patients were included in this series. The mean age was 56.3 ± 17.5 years. Six eyes had primary OAG and two eyes had secondary OAG. The majority of eyes (75%) had mild-to-moderate glaucoma. Five eyes underwent combined surgery, whereas the remaining three eyes underwent a standalone procedure. The mean baseline IOP was 22.9 ± 8.2 mmHg, and the mean IOP at 2 years after the procedure was 13.6 ± 2.8 mmHg. There was a 44.5% (10.2 ± 2.5 mmHg; P = 0.002) IOP reduction over 2 years. There was also a reduction in medication burden from a baseline mean of 3.4 ± 0.7 to 2.0 ± 1.2 (P = 0.17). There was no documented intraoperative adverse complication, whereas one patient required trabeculectomy post iStent for IOP control. iStent inject implantation safely reduced IOP and medication burden up to 24 months postoperative.

In 2002, the Chinese central government created a new rural cooperative medical system (NCMS), ensuring that both central and local governments partner with rural residents to reduce their copayments, thus making healthcare more affordable. Yet, significant gaps in health status and healthcare utilization persisted between urban and rural communities. Therefore, in 2009, healthcare reform was expanded, with (i) increased government financing and (ii) sharply reduced individual copayments for outpatient and inpatient care. Analyzing data from China's Ministry of Health, the Rural Cooperative Information Network, and Statistical Yearbooks, our findings suggest that healthcare reform has reached its preliminary objectives-government financing has grown significantly in most rural provinces, especially those in poorer western and central China, and copayments in most rural provinces have been reduced. Significant intraprovincial inequality of support remains. The central government contributes more money for poor provinces than for rich ones; however, NCMS schemes operate at the county level, which vary significantly in their level of economic development and per capital gross domestic products (GDP) within a province. Data reveal that the compensation ratios for both outpatient and inpatient care are not adjusted to compensate for a rural county's level of economic development or per capita GDP. Consequently, a greater financial burden for healthcare persists among persons in the poorest rural regions. A recommendation for next step in healthcare reform is to pool resources at prefectural/municipal level and also adjust central government contributions according to the GDP level at prefectural/municipal level.

Background Glaucoma is primarily characterized by the damage of retinal ganglion cells.The macular ganglion cell complex (GCC)thickness can be quantitatively measured using spectral domain optical coherence tomography(SD-OCT). Objective This clinical study was to explore the macular GCC thickness change in primary open-angle glaucoma (POAG) patient with SD-OCT. Methods A serial case-controlled study was designed.A total 101 eyes of 101 POAG patients and 41 normal eyes of 41 age- and refract power-matched normal subjects were cnrolled in the study.POAG patients were assigned to normal perimetry POAG group,early stage POAG group,advanced POAG group and late stage POAG group.Average macular GCC thickness(GCC-Avg),superior GCC thickness(GCC-Sup) and inferior GCC thickness (GCC-Inf)of subjects were measured by SD-OCT and compared among POAG patients and normal controls.Peripapillary retinal nerve fiber layer(RNFL) thickness was measured with time domain OCT(TD-OCT).The correlation between GCC thickness with RNFL thickness or mean deviation(MD) of perimetry were evaluated and analyzed.Informed consent was obtained from each patient prior to entering this study.Results GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the normalperimetry POAG group and early stage POAG group compared with the normal control group (GCC-Avg:t =5.411,10.247,P ＜ 0.01 ; GCC-Sup:t =6.171,9.484,P＜ 0.01 ; GCC-Inf:t =5.281,8.592,P ＜ 0.01 ).Also,GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the advanced POAG group compared with the early stage POAG group ( GCC-Avg:t =4.246,P＜0.01 ; GCC-Sup:t - 2.419,P - 0.019 ; GCC-Inf:t =4.636,P＜0.01 ),and GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the late stage POAG group compared with the advanced POAG group (GCC-Avg:t=2.095,P=0.040;GCC-Sup:t=2.756,P＜0.01:GCC-Inf:t =2.018,P =0.040 ).The positive correlations were seen between GCC-Avg thickness,GCC-Sup thickness,GCC-Inf thickness and RNFL-Avg thickness,RNFL-Sup thickness,RNFL-Inf thickness respectively( r =0.802,0.825,0.856,P ＜ 0.01 ).MD value of perimetry was positive correlated with GCC-Avg thickness in POAG patients ( r =0.601,P ＜ 0.01 ). Conclusions SD-OCT can quantitatively measure and differentiate the GCC thickness in POAG patients.The GCC thickness gradually decreases with the development of POAG.There exist a well correlation between visual field defect and RNFL thinning. Key words: Optical coherence tomography/spectral domain, time domain; Retina; Nerve fiber layer; Glaucoma