advertisement
Abstract #15341 Published in IGR 1-3
Glaucoma care in Olmsted County, Minnesota, 1965-1980: filtering surgery and vision outcomes (editorial; comment)
Gaasterland DEArchives of Ophthalmology 1999; 117: 1236-7
In this editorial two papers are discussed both by Hattenhauer and colleagues, one on the probability of blindness from open angle glaucoma and the other on the probability on filtration surgery in glaucoma. The editor states that knowledge is sparse on the long-term outcome of glaucoma management. The two studies discussed concern a racially homogeneous population. Some 295 patients were involved of whom 60% had so-called ocular hypertension as diagnosed in the period between 1965 through 1980. The surgery report states that some 40 % of patients with glaucomatous damage had undergone filtering surgery at 20 years of follow-up compared to 15% in those with ocular hypertension. Furthermore those with glaucomatous damage at onset had a more than 50 % chance of blindness in at least one eye by 20 years. Vision loss increased nearly linearly with time. The reader may also be aware of a different editorial by Quigley in which he pointed out that most glaucoma patients do not have these twenty years after discovery of their disease. The present editor points out that these two are retrospective studies with all the involved limitations. We do not know about the possible relation between filtering surgery and loss of vision. Other trials with different follow-up period and different management have reported lower rates of visual function loss. We now have better glaucoma medications and improved surgery compared to the years before 1980. This author warns that the results of the discussed studies might not forecast the present day likelihood of glaucoma surgery or vision outcome. Physicians should avoid the temptation to use these results when discussing present day glaucoma management and outcomes with their patients.
Classification:
1.5 Glaucomas as cause of blindness (Part of: 1 General aspects)
12.1 General management, indication (Part of: 12 Surgical treatment)
