A recent study recently published in the American Journal of Ophthalmology has evaluated the question of whether a patient’s vision can be improved following surgery to reduce intraocular pressure. Glaucoma is a group of diseases that result in a characteristic pattern of damage to the optic nerve and peripheral visual field. This disease is frequently associated with elevated pressure inside the eye. The damage brought on by this disease is thought to be progressive and irreversible although it can be slowed down by measures that reduce pressure inside the eye. Reducing the pressure is the only way to slow the progression of glaucoma damage, and, as this study suggests, there remains the possibility of reversing some of the damage.
A trabeculectomy is the most common type of glaucoma surgery. This procedure involves creating a new pathway for fluid to drain out of the eye. The pressure decrease from a trabeculectomy has been known to slow the damage caused by glaucoma. This small study suggests that the field of vision following the surgery may improve after glaucoma surgery.
Another well-known procedure involves the implantation of a drainage device for the control of glaucoma related pressure. This step is most commonly taken when prior trabeculectomies have been unsuccessful or the eye contains a significant amount of scar tissue. Various drainage devices are currently available. Though they have their differences, each is designed to draw fluid from inside the eye into an external reservoir. For difficult cases, or those who are not good candidates for a trabeculectomy, the implantation of a drainage device is an acceptable option.
While both of these procedures have long been used for limiting glaucoma damage, the results of this study are even more encouraging. Not only can patients look forward to a higher probability of retaining their level of vision, but advances in technology have made it possible to bring about some improvement for at least three months. It is unclear however whether this improvement is permanent, real or even clinically significant. Patients should still make sure that they do anything they can to prevent damage since at this point most of it is irreversible. Nevertheless, this study, although small and of short duration is encouraging. This improvement may also be used to compare different surgical interventions in the future.
American Journal of Ophthalmology
Short-Term Enhancement of Visual Field Sensitivity in Glaucomatous Eyes Following Surgical Intraocular Pressure Reduction
Am J Ophthalmol 2014 Nov 13; TM Wright, I Goharian, SK Gardiner, M Sehi, DS Greenfield