New Delhi: A new study from the All India Institute of Medical Sciences (AIIMS), Jodhpur, has reported that trabeculectomy—a commonly performed glaucoma surgery—significantly improves the quality of life (QoL) of patients with moderate to severe forms of the disease, compared with those managed only through long-term medication.
Glaucoma, one of the leading causes of irreversible blindness, gradually damages the optic nerve and erodes quality of life on multiple fronts. As visual fields shrink, routine activities become increasingly difficult, heightening dependence on caregivers. The chronic, progressive nature of the condition, coupled with lifelong medication use, often adds substantial mental stress and financial burden, contributing to anxiety and depression among patients.
Earlier population-based data have shown that individuals with glaucoma-related vision impairment face a higher risk of mortality, particularly from metabolic, circulatory and respiratory causes, and even suicide—highlighting the urgent need for effective interventions to preserve sight.
The AIIMS Jodhpur study, published in the Indian Journal of Medical Research (IJMR), followed 46 patients (54 eyes) between October 2022 and December 2023. All participants underwent trabeculectomy after failing to achieve target intraocular pressure (IOP) despite maximal medical therapy.
Most patients were using three or more topical anti-glaucoma drops before surgery, with some also requiring systemic treatment for pressure control. Post-operatively, the medication load dropped dramatically—from an average of 2.57 eye drops to just 0.35, with no patient needing systemic drugs. This steep reduction, lead author Dr. Kirti Jaisingh said, was a major contributor to improved QoL scores.
Sustained pressure control was another key outcome. Mean IOP decreased from a baseline 18.9 mmHg to around 12 mmHg at six months, with visual acuity remaining stable. Across all severity categories, patients who underwent surgery recorded significantly lower GQL-15 scores—a standard QoL assessment tool—than those on medical therapy alone. Those with severe disease, though starting at the poorest baseline, experienced the greatest improvement.
Functional areas showing marked gains included peripheral vision, dark adaptation, glare sensitivity and outdoor mobility, the researchers reported.
While previous studies have offered mixed insights on whether surgery or long-term medication provides better QoL outcomes, the Jodhpur team minimised bias by evaluating the same group of patients before and after surgery, offering a clearer picture of the benefits of trabeculectomy.
Co-author Dr. Kavita R. Bhatnagar noted that the procedure not only reduced the medication burden but also alleviated ocular surface irritation—common with chronic drop use—while enabling more dependable IOP control. The team stressed the importance of incorporating QoL measures into treatment planning, especially in resource-limited settings where sustaining multi-drug regimens can be challenging.
The research group also included Dr. Tapasya Rajpurohit, Dr. Jyoti Shakrawal, Dr. Seema Meena, Dr. Nikhil Agrawal and Dr. Manogya Jain, all from AIIMS Jodhpur.
Glaucoma encompasses a group of disorders that damage the optic nerve, often due to elevated eye pressure. Though lost vision cannot be restored, early detection and appropriate treatment can prevent or slow further loss. Experts recommend regular screening for people over 40, those with a family history of glaucoma, individuals with diabetes, and other at-risk groups.
Dr. Tanuj Dada, Professor of Ophthalmology at AIIMS, New Delhi, who has been regularly highlighting the disorder, said glaucoma is a major cause of blindness in India, yet 90% of people affected are not even aware they have the disease.
Glaucoma is of two types: open-angle glaucoma, which gradually reduces vision without any noticeable symptoms, and angle-closure glaucoma, an eye emergency that presents with sudden severe eye pain, headache and blurred vision, and can lead to rapid vision loss if not treated immediately, he added.
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