Trabeculectomy Can Improve Long-Term Visual Function in XXXX .

@entity1 @entity227 @entity1538 @entity1138 @entity409 @entity726 @entity989
PURPOSE: To measure the magnitude and direction of @entity227 ( @entity227 ) rates of change in @entity726 @entity1 after intraocular pressure (IOP) reduction with trabeculectomy. DESIGN: Retrospective, comparative, longitudinal cohort study. @entity1 : @entity1 with @entity1538 . METHODS: @entity1 who underwent trabeculectomy (Trab) with @entity1138 (74 eyes of 64 @entity1 ) with  >= 4  reliable @entity227 measurements before and after trabeculectomy and at least 4 years of follow-up before and after surgery were included. Decay or improvement exponential models were used to calculate pointwise rates of perimetric change before and after surgery. A separate comparison (Comp) group with unoperated @entity726 (71 eyes of 65 @entity1 ) with similar baseline damage, number of @entity227 tests, and follow-up was used to address possible regression to the mean. Proportions of @entity227 locations decaying or improving before and after surgery in the Trab group, and during the first and second halves of follow-up in the Comp group, were calculated. A  multivariate analysis was used to explore variables associated with @entity227 improvement. MAIN OUTCOME MEASURES: The rate of pointwise @entity227 change before and after surgery in the Trab group and Comp group. RESULTS: @entity1 in the Trab group were followed for 5.1  2.1 years (mean    standard deviation) before and 5.4  2.3 years after surgery, with 8.9  4.7 @entity227 tests before and 9.0  4.4 @entity227 tests after surgery. The mean rate of change for all @entity227 locations slowed from  -2.5  9.3%/year before surgery to  -0.10  13.1%/year after surgery (P  <  0.001). In the Trab group, 70% of locations decayed and 30% improved preoperatively; postoperatively, 56% decayed and 44% improved. The differences between the Trab and Comp groups were significant (P  <  0.0001, chi-square test). The magnitude of IOP reduction correlated with the excess number of @entity227 locations that exhibited long-term improvement postoperatively (P  = 0.009). In the Trab group, 57% of eyes had >= 10 improving @entity227 locations postoperatively. CONCLUSIONS: The results show that trabeculectomy slows the rate of perimetric decay and provides evidence of sustained, long-term improvement of visual function in @entity726 . These findings suggest the possibility of reversal of @entity409 of @entity989 and their central projections.
