{
  "abstract": "Aims To evaluate how different methods of managing multiple visits within predefined time windows affect intraocular pressure (IOP)-based success rates in glaucoma surgery studies.Methods We applied literature-based high IOP failure criteria to two cohorts of 934 and 1760 eyes undergoing trabeculectomy and deep sclerectomy (DS) with median follow-up of 41.4 months and 45.4 months, respectively. Failure was defined by IOP thresholds, loss of light perception, hypotony requiring revision or additional IOP-lowering surgery. Visits were grouped into guideline-based windows and six visit-managing strategies were applied to all visits, mean, lowest, highest, median and closest IOP to the recommended time point. We calculated Kaplan-Meier success rates for each visit-managing strategy. Visual field (VF) analysis was conducted on patients in the trabeculectomy cohort with ≥4 VFs in ≥2 years post-surgery.Results For the 21 mm Hg threshold, 5-year success was highest with the lowest IOP (trabeculectomy: 54.8%; DS: 74.5%), followed by closest IOP (trabeculectomy: 46.7%; DS: 67.6%), the median (trabeculectomy: 46.9%; DS: 69.1%) and mean IOP (trabeculectomy: 46.3%; DS: 68.6%). Success rates were lower with peak IOP (trabeculectomy: 39.3%; DS: 60.4%) and all visits IOP (trabeculectomy: 38.8%; DS: 61.0%). In the VF subset, eyes classified as failures demonstrated significantly faster mean deviation (MD) progression than those classified as successes although substantial overlap in the distribution of MD rates persisted between groups under every strategy.Conclusions Visit-managing strategies influence reported success rates. None of the evaluated approaches achieved a clear separation in VF progression rates, underscoring the inherent limitations of IOP-threshold-based classifications.",
  "authors": [
    {
      "affiliations": [
        "Department of Health Sciences, Università del Piemonte Orientale “A.Avogadro”, Novara, Italy",
        "IRCCS Fondazione Bietti, Rome, Italy"
      ],
      "name": "Alessandro Rabiolo"
    },
    {
      "affiliations": [
        "Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA"
      ],
      "name": "Daniela Khaliliyeh"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea (the Republic of)"
      ],
      "name": "Sang Wook Jin"
    },
    {
      "affiliations": [
        "Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA"
      ],
      "name": "Esteban Morales"
    },
    {
      "affiliations": [
        "Eye Clinic, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy"
      ],
      "name": "Luca Rossetti"
    },
    {
      "affiliations": [
        "Ophthalmology, Calderdale & Huddersfield NHS Trust, Huddesrsfield, West Yorkshire, USA",
        "Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK"
      ],
      "name": "Nitin Anand"
    },
    {
      "affiliations": [
        "NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK"
      ],
      "name": "Giovanni Montesano"
    },
    {
      "affiliations": [
        "IRCCS Fondazione Bietti, Rome, Italy"
      ],
      "name": "Francesco Oddone"
    },
    {
      "affiliations": [
        "Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA"
      ],
      "name": "Joseph Caprioli"
    },
    {
      "affiliations": [
        "Department of Health Sciences, Università del Piemonte Orientale “A.Avogadro”, Novara, Italy",
        "Department of Ophthalmology, University Hospital Maggiore della Carità, Novara, Italy"
      ],
      "name": "Stefano De Cillà"
    }
  ],
  "title": "Impact of visit schedule on estimated success rates in glaucoma surgical studies",
  "uid": "f9e8c0e0-6e3b-5619-a3d2-e524cc2ab2fd"
}