Comparison Of Three-Year Outcoms Following Trabeculectomy In Primary Open-Angle And Pseudoexfoliation Glaucoma

To evaluate and compare the three-year surgical outcomes of trabeculectomy in patients with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG), specifically analyzing intraocular pressure (IOP) control, reduction in antiglaucomatous medication use, and overall surgical success.

Zonguldak, Bülent Ecevit  University, Zonguldak Türkiye

This retrospective, single-center study included 150 eyes (95 POAG and 55 PEXG) that underwent trabeculectomy and were followed for up to three years. IOP measurements and the number of IOP-lowering medications were recorded preoperatively and at 1 month, 6 months, 1 year, 2 years, and 3 years postoperatively. Surgical success was defined as achieving an IOP between 7–18 mmHg without requiring additional glaucoma surgery. Complete success referred to achieving target IOP without medications, while qualified success allowed the use of topical therapy.

Both groups demonstrated significant and sustained IOP reduction throughout the follow-up period (P < 0.01). Mean preoperative IOP was 34.6 mmHg in the POAG group and 30.8 mmHg in the PEXG group. Postoperatively, IOP stabilized around 14–16 mmHg in both groups across three years. Medication burden decreased significantly in both groups, from 3.6 medications preoperatively to 0.6 in POAG and 0.9 in PEXG at three years (P < 0.01). Surgical outcomes were comparable between groups, with qualified success achieved in 74% of eyes in both groups and complete success in 64% (POAG) and 62% (PEXG), without statistically significant differences.

Trabeculectomy achieves significant and sustained intraocular pressure reduction over a three-year follow-up period in both primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG). Although baseline IOP values differed between groups, long-term surgical outcomes were comparable. Both glaucoma types demonstrated similar success rates and a substantial decrease in postoperative medication requirements, indicating that trabeculectomy is equally effective in maintaining IOP control in POAG and PEXG patients.