title: Earlier trabeculectomy.
abstract: This is a preliminary report of a collaborative, prospective, randomised trial of management of primary open angle glaucoma where conventional management using medical therapy followed by trabeculectomy only in unsuccessful cases (Group A) was compared with trabeculectomy as the primary form of treatment supplemented where necessary by medical therapy (Group B). Using one eye of each patient 40 eyes were available at one year and 14 eyes at two years after entry to the trial. The two groups were comparable for age, sex, intraocular pressure before treatment, visual acuity, visual fields and other features. Seven of the 22 eyes in Group A (31 per cent) had required operation in the first year and two of the 18 eyes in Group B (11 per cent) had required supplementary medical therapy in the same period. Trabeculectomy was more effective in lowering intraocular pressure than medical treatment. No statistically significant differences in visual function or disc appearances are yet detectable but there is a trend in favour of trabeculectomy as a primary procedure (Group B).
mesh_terms: D000368:Aged; D002986:Clinical Trials as Topic; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors; D014129:Trabecular Meshwork / Q000601:surgery*; D014792:Visual Acuity; D014794:Visual Fields