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    Can retinal ganglion cellular dysfunction reverse itself by IOP decrease after trabeculectomy?

    Los Angeles—Ganglion cellular dysfunction may reverse itself as the result of a substantial decrease in IOP after trabeculectomy in patients with glaucoma, according to John Mark S. de Leon, MD.

    This finding was based on a study in which Dr. de Leon and colleagues investigated the changes in the visual field threshold sensitivity in the fast and slow components of visual field decay in patients after trabeculectomy.

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    The investigators retrospectively reviewed the visual fields of patients with open-angle glaucoma who had undergone trabeculectomy, explained Dr. de Leon, a research fellow in ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles. Four or more reliable preoperative and postoperative visual field tests were available for all eyes. Patients were included in the study when the last preoperative and first postoperative visual field tests were obtained within 1.5 years of the surgery and when the patients were followed preoperatively and postoperatively for a minimum of 2 years.

    Every visual field location was assigned to either fast or slow decay components based on point-wise exponential regression and the decay curves were fit to the sensitivities of the preoperative and postoperative visual field measurements separately. The sensitivity difference between the first postoperative and the last preoperative visual field value at each test location was estimated by the exponential curve fits.

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