Læknablaðið - Apr 2020, Page 24

192 LÆKNAblaðið 2020/106
R A N N S Ó K N
Introduction: Glaucoma is a degenerative disease in the optic
nerve with associated visual field defects (VFD). Trabeculectomy
is the most common glaucoma surgery. Surgery is indicated if
glaucomatous optic neuropathy progresses despite tolerated med-
ical treatment or in patients with severe VFD. The purpose of this
paper is to describe the severity of visual field damage in patients
undergoing their first trabeculectomy in Iceland.
Methods: A retrospective review of medical records of all patients
with open angle glaucoma that underwent first trabeculectomy
at Landspítali University Hospital, from June 2013 to March 2016.
Visual fields were examined by Octopus automated perimetry and
the severity of glaucoma damage was staged according to the
mean defect (MD).
Results: 86 eyes were included in the study, mean age 75 ± 11
years, 57% men. Patients used on average three IOP lowering
medications. Mean MD at referral to surgery was 13.4 ± 7.7dB (min
0.8dB, max 26.2 dB), 21% had early glaucomatous damage (MD <
6dB), 23% moderate (MD 6-12 dB) and 56% severe (MD > 12).
Conclusion: VFD at referral to surgery varied from mild VFD to
severe damage. Like clinical guidelines recommend, treatment
seems to be individualized and the most common indication for
surgery was increased VFD despite medical treatment. Mean MD
at referral to surgery was high compared to other studies. Eyes
with severe VFD had on average lower IOP and thinner cornea. This
might indicate that great emphasis is placed on high IOP and per-
haps too little emphasis on VFD and cornea thickness.
Glaucomatous visual field loss in eyes undergoing first trabeculectomy in Iceland
ENGLISH SUMMARY
1Ophthalmology department of Skanes University hospital, Sweden, 2University of Iceland, 3Ophthalmology department of Landspitali University Hospital, Iceland.
Key words: Glaucoma, trabeculectomy, visual defect, open angle glaucoma, pseudoexfoliation glaucoma.
Correspondence: Elín Björk Tryggvadóttir, elinb.86@gmail.com
Elín Björk Tryggvadóttir1
Sveinn Hákon Harðarson2
María Soffia Gottfreðsdóttir2,3
DOI:10.17992/lbl.2020.04.576