Target intraocular pressure for stability of visual field loss progression in normal-tension glaucoma.
OBJECTIVE
To determine the target intraocular pressure (IOP) level in normal-tension glaucoma (NTG) for visual field (VF) stability following trabeculectomy.


METHODS
Forty eyes of 40 patients who underwent trabeculectomy were enrolled in this study. Progression was determined by a decrease in the Advanced Glaucoma Intervention Study VF defect score of four or more points. The Kaplan-Meier life table method was employed to compare the postoperative VF stability with predetermined IOP levels.


RESULTS
The mean postoperative follow-up period was 12 years. At the final visit, the IOP was reduced from 15.2 to 9.4 mmHg on average (P < 0.0001). Reductions in IOP of 20% from baseline were achieved in 70.0% of eyes. The cumulative probability of VF stability was 92.7% in patients having an IOP reduction of >20%, whereas all patients in the poorly controlled IOP group showed progression (P < 0.0001). When IOP values of 9, 10, 11, and 12 mmHg were employed as the cutoff, the best VF prognosis was attained in eyes with a postoperative IOP of 10 mmHg.


CONCLUSIONS
An IOP reduction of at least 20% from baseline or IOP <or=10 mmHg is recommended as the target postoperative IOP in progressive NTG.
Aoyama
Akira
A
Department of Ophthalmology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Japan.
Ishida
Kyoko
K
Sawada
Akira
A
Yamamoto
Tetsuya
T
D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D053208:Kaplan-Meier Estimate; D057066:Low Tension Glaucoma / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D011336:Probability; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy; D014786:Vision Disorders / Q000503:physiopathology*; D014794:Visual Fields
D000477:Alkylating Agents; D016685:Mitomycin
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