Vision Loss and Recovery After Trabeculectomy

Abstract

Clinical trials^1-4 have shown that the lowering of intraocular pressure (IOP) is associated with reduced progression of glaucomatous visual field (VF) loss. von Graefe^5,6 was the first to report that central vision may be compromised soon after surgery in eyes with chronic glaucoma and contracted VFs. Since then, the recommendation of glaucoma filtration surgery in patients with severely compromised VFs has been debated for fear of loss of central vision. Evidence for this so-called snuff-out phenomenon arose from earlier studies^7-11 that seemed to confirm the original observations by von Graefe. However, other investigators argued that they found no evidence for rapid postoperative progression of VF defects and that the risk of glaucoma surgery was warranted regardless of the severity of preoperative VF loss.^12-16