Study Links Trabeculectomy To Improved Quality Of Life In Glaucoma Patients

A new study from the All India Institute of Medical Sciences (AIIMS), Jodhpur, has found that patients with moderate to severe glaucoma (a deeply debilitating diseases of eyes and for which there is currently no cure) experience a measurable improvement in quality of life (QoL) after undergoing trabeculectomy, compared with those managed only through long-term medication.

Glaucoma erodes quality of life in multiple ways. As vision deteriorates, everyday tasks become more challenging, increasing dependence on caregivers. The chronic nature of the disease and lifelong reliance on medications exert a heavy mental and financial strain, often triggering anxiety and depression.

Glaucoma slowly leads to irreversible blindness, caused by damage to the nerves at the back of the eye. It's often, but not always, linked to elevated pressure in the eye

In a nationwide, population-based longitudinal analysis, glaucoma patients with vision impairment were also found to face a heightened risk of mortality, with leading causes including metabolic, circulatory and respiratory diseases, as well as suicide-related factors—underscoring the urgency of preventing vision loss through effective management.

The prospective AIIMS, Jodhpur study, conducted between October 2022 and December 2023, at its Ophthalmology Department evaluated 46 patients (54 eyes) who underwent trabeculectomy after failing to reach target intraocular pressure (IOP) despite maximal medical therapy. The study is published in the Indian Journal of Medical Research (IJMR).

Researchers noted that most patients were using at least three topical anti-glaucoma drops, with many also requiring systemic medications. After surgery, the mean number of topical drugs fell sharply from 2.57 to 0.35, and no patient required systemic therapy. This steep reduction, lead author Dr. Kirti Jaisingh said, likely contributed to the improved QoL scores.

Trabeculectomy yielded a sustained drop in IOP—from a baseline 18.9 mmHg to about 12 mmHg at six months—while visual acuity remained stable.

Across mild, moderate and severe disease categories, surgically treated patients demonstrated significantly lower GQL-15 scores than those on medical therapy, indicating better QoL. Those with severe glaucoma, though starting with the poorest QoL, showed the most pronounced improvement.

Key functional domains—peripheral vision, dark adaptation, glare sensitivity and outdoor mobility—showed statistically significant gains, said the study.

While earlier studies showed mixed findings on whether medical or surgical management offered better QoL, the AIIMS team minimised bias by assessing the same cohort before and after surgery, offering a clearer view of post-trabeculectomy benefits.

Co-author Dr. Kavita R. Bhatnagar emphasised that trabeculectomy can meaningfully enhance QoL in moderate to severe glaucoma by reducing medication burden, alleviating ocular surface discomfort and achieving more reliable IOP control. The authors also highlighted the need to integrate QoL indicators into clinical decisions, especially in low-resource settings where long-term multi-drug therapy may be difficult to sustain.

The study team also included Dr. Tapasya Rajpurohit, Dr. Jyoti Shakrawal, Dr. Seema Meena, Dr. Nikhil Agrawal and Dr. Manogya Jain, all from AIIMS, Jodhpur.

Glaucoma is a group of eye diseases damaging the optic nerve, often due to high intraocular pressure (IOP), leading to gradual peripheral vision loss and potential blindness if untreated. While irreversible vision loss can't be restored, early detection via dilated eye exams and treatments can slow or prevent further damage. Regular checkups for at-risk individuals (over 40, family history, certain ethnicities, diabetes) are suggested.