Outcomes of surgical intervention in primary glaucoma at a tertiary eye care centre

Background: Aim of study was to evaluate the outcomes of surgical intervention in diagnosed primary glaucoma cases. Methods: This is a prospective observational study done on 55 cases for evaluating outcomes of surgical intervention in primary glaucoma, conducted in ophthalmology department at a tertiary eye care hospital in central India over a period of 18 months. Standard trabeculectomy surgery was performed for all cases by a single senior surgeon. Medical parameters that were studied as pre-operative and post-operative comparison of visual acuity, Intraocular pressure (IOP), fundoscopy, gonioscopy, OCT showing retinal nerve fibre layer (RNFL) thickness, perimetry showing field of vision and post-op complications. Results: This study compares multiple factors in diagnosed primary glaucoma cases to define success of trabeculectomy surgery. Post-operative results showed significant improvement in terms of IOP, visual field index (VFI), UCVA and BCVA, gonioscopy, fundus examination, RNFL thickness on OCT. After taking into consideration all these factors pre and post-operatively, success rate of trabeculectomy evaluated at 6 monthly follow up came out to 87.27%, which includes 52.72% cases showing complete success and 34.54% cases showing qualified success, while remaining 12.72% cases showed failure due to complications like leaking bleb with hypotony, bleb failure, irido-dialysis and persistent angle closure where post-op IOP control was not achieved, leading to failure of filtration. Conclusions: Trabeculectomy is fairly a successful surgical management to achieve IOP control and to halt the progression of glaucomatous optic neuropathy, also to prevent further deterioration of vision and field changes in diagnosed Primary glaucoma in the short to medium term follow-up.