Aside from cataract development (for phakics) and posterior capsular opacification (for pseudophakes), are there other factors that could decrease short-term (3 months to a year) visual field sensitivity after a successful trabeculectomy?
Dear,
Corneal problems can diminish sensitivity, but are normally not progressive. (Corneal complications of glaucoma surgery.Hau S1, Barton K.Curr Opin Ophthalmol. 2009 Mar;20(2):131-6. doi: 10.1097/ICU.0b013e328325a54b.)
Choroidal detachment or hypotonous maculopathy can degrade the visual field, depending on the severity. However, even severe choroidal problems can recover without additional visual field damage (Good functional recovery following intervention for delayed suprachoroidal haemorrhage post bleb needling: a case report. Cannon et al. J Med Case Rep. 2008 Mar 13;2:81. doi: 10.1186/1752-1947-2-81.)
Ocular decompresion retinopathy will be evident on fundus examination.
Wipe-out in eyes with split fixation is a dreadful and controversial phenomenon, several prospective studies being unable to demonstrate the occurrence of it (Prospective evaluation of early visual loss following glaucoma-filtering surgery in eyes with split fixation. Balekudaru et al. J Glaucoma. 2014 Apr-May;23(4):211-8., and Risk of sudden visual loss following filtration surgery in end-stage glaucoma. Topouzis et al. Am J Ophthalmol. 2005 Oct;140(4):661-6).
However a large retrospective study found a 2% risk of permanent severe unexplained vision loss. (Vision loss and recovery after trabeculectomy: risk and associated risk factors. Francis et al. Arch Ophthalmol. 2011 Aug;129(8):1011-7)
Hope this helps.
best wishes,
Thibaut Devogelaere
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