Concluding Comment

The clinician needs to keep in mind that the goal of glaucoma therapy is to sustain the vision-related quality of life and to maintain both the visual field and the structural integrity of the optic nerve. When the clinician is considering whether or when to advance from medical to surgical therapy, individual patient variations need to be taken into account. Selection of a target IOP for each individual eye is important, and surgical intervention should be considered if this target is not achieved with the appropriate medical therapy. Although these indications represent a prevailing view, they should be considered only as guidelines,5,6 and not as a substitute for the experience and judgment of an individual ophthalmologist. Ophthalmic practice is continually evolving, and indications are likely to change as new knowledge is acquired.

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