Vision‐related quality of life following trabeculectomy versus Baerveldt glaucoma implant: Five‐year results from a randomized clinical trial
Ionela Popescu‐Giovanitsas, Jarinne E. Woudstra‐de Jong, Johannes R. Vingerling, Peter W. T. de Waard, Pieter W. M. BonnemaijerAbstract
Purpose
To assess the vision‐related quality of life (VRQoL) in glaucoma patients over 5 years after primary Baerveldt glaucoma implant (BGI) or trabeculectomy (TE) using a secondary analysis of a randomized clinical trial.
Methods
Patients were randomized to undergo TE or receive a BGI. Preoperative and annual postoperative evaluations included testing of visual acuity (VA), visual field (VF) and VRQoL. Active intraocular pressure‐lowering medications were documented at each visit. VRQoL was assessed using the National Eye Institute 39‐item Visual Function Questionnaire (NEI VFQ‐39), and responses were analysed using Rasch modelling. A linear mixed model was applied, with random intercept (patient level) and fixed effects for sex, age, VA, VF mean deviation (MD) and number of intraocular pressure‐lowering medications.
Results
The study included 119 patients (60 TE; 59 BGI). VRQoL significantly declined after both surgeries (visual functioning scale: TE β = −4.59, 95% CI: −7.63 to −1.54, p = 0.003; BGI β = −4.13, 95% CI: −6.83 to −1.43, p = 0.003; socioemotional scale: TE β = −6.16, 95% CI: −10.30 to −2.03, p = 0.003; BGI β = −4.35, 95% CI: −7.33 to −1.37, p = 0.004). However, no significant difference in VRQoL was found between TE and BGI postoperatively. Diplopia following BGI implantation was reported in 28.6% at 1 year and 26.5% at 5 years, and it was not associated with a significant change in VRQoL.
Conclusion
Although VRQoL significantly declined after both TE and BGI, no significant difference was observed between the two surgeries over 5 years. These findings indicate broadly comparable patient‐reported outcomes between both procedures; however, VRQoL assessment was limited by power and instrument sensitivity.