[Review of 402 goniotrephinations]

Trabeculectomies. A long-term study

This study comprises 277 primary open-angle glaucomas in 239 patients followed up to 10 years after trabeculectomy. Sixty-four per cent had capsular glaucoma and 36% simple glaucoma. The number of cases showing no progression of glaucoma damage and not needing additional medical therapy decreased slowly with time. Seventy-five per cent showed no progress after one year, 70% after 2 years, 57% after 5 years and 42% after 10 years. There was a significant trend that fewer capsular glaucomas progressed than simple glaucomas. High pressure levels before trabeculectomy did not indicate a bad prognosis. Cases with advanced or moderate glaucomatous damage seemed to have the same prognosis. Cataract was a common complication; a 50% reduction of preoperative visual acuity was found in 37% of eyes after 5 years of follow-up.

Ten year prospective follow-up of a glaucoma operation. The Double Flap Scheie in primary open angle glaucoma

The results of a longterm prospective follow-up study after the 'Double Flap' Scheie filtering operation are presented. Fifty-two eyes of 47 patients with primary open angle glaucoma (POAG) were operated; after ten years 29 eyes of 24 patients could be examined. Twenty patients (43%) had died, in three follow-up was incomplete. The two and four year results have been published earlier. In the 29 eyes the mean intraocular pressure (IOP) without medical therapy rose from 15.8 mm Hg at five years to 16.3 mm Hg at ten years (not significant). Additional medical or surgical treatment was necessary in 35% of the eyes. Diurnal variation and outflow facility remained stable. During the ten years 13 eyes showed some deterioration of visual fields. Nearly all clinically important deterioration occurred within five years after the operation. Cataract progression was noticed in 45% (13 of 29); four times a lens extraction was performed (13%). Complete success of the operation, as judged by stable visual fields and IOP levels at or under 21 mm Hg without additional medical or surgical therapy was reached in 13 of 20 eyes (45%). Based on IOP alone the success rate was 62% without and 93% with additional treatment.