Vision-related quality of life following trabeculectomy versus Baerveldt glaucoma implant: Five-year results from a randomized clinical trial

22/06/2026

AI Summary

Vision related quality of life significantly declined after both trabeculectomy and Baerveldt implant over five years.
No significant difference in postoperative VRQoL between trabeculectomy and Baerveldt implant over five years.
Diplopia occurred in about 28% at one year and 26% at five years after Baerveldt implant, without significant VRQoL impact.

AI Summary

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.

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).

CONCLUSION: Although VRQoL significantly declined after both TE and BGI, no significant difference was observed between the two surgeries over 5 years.

Basic summary

Acta Ophthalmol. 2026 Jun 22. doi: 10.1111/aos.70176. Online ahead of print.

ABSTRACT

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.

PMID:42325056 | DOI:10.1111/aos.70176

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