Click here to read the Cover Story, "Advanced glaucoma calls for aggressive, personalized care."
The reason the NICE guidelines advise trabeculectomy at presentation with advanced disease is simply that the greatest risk factor for severe visual loss in glaucoma is advanced disease at presentation.
Randomized clinical trials such as the Moorfields Primary Treatment Trial and the Collaborative Initial Glaucoma Treatment Study have established clearly that trabeculectomy achieves greater IOP lowering than medical therapy in patients with primary glaucomas who have no risk factors for