Dr. Robert Cykiert, an ophthalmologist at New York University Medical Center and a clinical associate professor of ophthalmology at New York University School of Medicine in New York City, said that this study "says that one should try trabeculectomy procedure first, if you can."
In these patients, "experience and intuition says that additional trabeculectomy surgery usually won't work. That's why we go to a glaucoma drainage device," Cykiert said. "This study indicates that if there's any belief you can get away with doing a trabeculectomy procedure, you are better off doing that then putting in the drainage device."
These results will make people a little more conservative, Cykiert said. "Some glaucoma specialists jump ahead to the glaucoma drainage device sooner than they might or should," he noted.
In the second study, Dr. Jason W. Much, from the Department of Ophthalmology at the University of Virginia in Charlottesville, and his colleagues looked at the charts of 64 patients with end-stage glaucoma. All these patients were considered legally blind at the start of the study.
All patients underwent trabeculectomy or laser trabeculoplasty, where tissue is removed by laser. The researchers found that, despite impaired vision, these patients did not become blind.
"Relentless progression to [complete] blindness is not the norm in treated patients," Much said in a statement. "Patients should be encouraged that treatment is not futile. They may retain their visual acuity for many years and be able to perform simple tasks of daily living and enjoy reading and hobbies."
Cykiert said this study contradicts what has been thought for a long time. "The thinking has been that treating patients with end-stage glaucoma is often unsuccessful, because they wind up losing their vision," he explained.
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