Prospective, randomized, clinical trials of glaucoma treatment have convincingly shown the efficacy of intraocular pressure (IOP) reduction to slow the progression of glaucomatous optic nerve damage. Prospective, randomized, long-term studies have covered a spectrum of disease from early to late, and from normal to high pressures.1-3 Others included a comparison of medical vs surgical treatment,4 and even treatment vs no treatment.5 All have demonstrated the strength of IOP reduction to slow the progression of disease, as measured by visual function and optic nerve structure. There is no longer any doubt (though some of us never doubted) that robust IOP reduction works in most patients.
Caprioli J. Intraocular Pressure Fluctuation: An Independent Risk Factor for Glaucoma? Arch Ophthalmol. 2007;125(8):1124–1125. doi:10.1001/archopht.125.8.1124
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