title: Effectiveness of Single-Digit IOP Targets on Decreasing Global and Localized Visual Field Progression After Filtration Surgery in Eyes With Progressive Normal-Tension Glaucoma.
abstract: To examine the effectiveness of achieving single-digit intraocular pressure (IOP) targets with filtration surgery on decreasing global and localized visual field (VF) progression in eyes with progressive normal-tension glaucoma (NTG).
  
  
  
  A retrospective chart review was conducted to identify NTG patients who underwent trabeculectomy with mitomycin C between 2006 and 2010 for progressive VF loss with preoperative IOP≤15 mm Hg during the 12 months before surgery. All eyes had glaucomatous optic neuropathy and progressive VF loss, uncontrolled IOP on maximum therapy, and a minimum of 2 baseline preoperative and 4 postoperative VF examinations. VF progression was assessed using Guided Progression Analysis (GPA) and Progressor software.
  
  
  
  Fifteen eyes of 14 patients (mean age 71.8±7.5 y) were enrolled with mean follow-up of 71±26 months. Mean postoperative IOP (8.5±3.5 mm Hg) was significantly (P<0.001) reduced compared with preoperatively (13.1±1.5 mm Hg). The probability of achieving an IOP goal ≤10 mm Hg was 66% at 4 years' follow-up. The overall rate of postoperative VF progression using any method was 13.3% (1 eye using Progressor; 1 eye using GPA and Progressor). Average postoperative slope of MD (-0.25±0.86 dB/y) and pattern SD (0.49±0.83 dB/y) were improved (P=0.05 and 0.07) compared with the preoperative slopes (-1.05±0.66 and 1.21±0.71 dB/y).
  
  
  
  Achieving single-digit IOP targets with filtration surgery has a beneficial effect on reducing global and localized rates of VF progression in NTG eyes with progression at low IOP.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Shawn M
authors.initials: SM
authors.lastname: Iverson
authors.forename: Scott K
authors.initials: SK
authors.lastname: Schultz
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.forename: William J
authors.initials: WJ
authors.lastname: Feuer
authors.forename: David S
authors.initials: DS
authors.lastname: Greenfield
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D057066:Low Tension Glaucoma / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000503:physiopathology / Q000601:surgery*; D011336:Probability; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D014794:Visual Fields / Q000502:physiology*