AIM: To evaluate the effectiveness of Mecobalamin on the visual field and retinal nerve fiber layer(RNFL)thickness in patients with advanced glaucoma after trabeculectomy.

METHODS: This was a retrospective observational case series. We chosed 57 cases(57 eyes)operated, whose high intraocular pressure had been relieved after trabeculectomy. Patients were randomly selected and divided into treatment group 28 cases(28 eyes), and control group 29 cases(29 eyes)(conventional treatment group). The treatment group received both conventional therapy and Mecobalamin 500μg, 3 times a day for 6 months. The mean defect(MD)and pattern standard deviation(PSD)were strictly measured by Humphrey 750i and the total and regional mean RNFL thickness were measured using a Stratus OCT-3(Carl Zeiss Meditec, Dublin, CA)at the time of discharge from hospital and at 6 months. Independent-samples t test was used to compare the results obtained from these two groups.

RESULTS: At 6 months, MD: treatment group(-13.30±4.03)dB, control group(-18.51±4.33)dB, PSD: treatment group(5.64±0.48)dB, control group(8.21±2.47)dB. There were statistically significant differences(t =-2.112, P=0.049; t =-2.436, P=0.025)in MD and PSD between the two groups. And the RNFL thickness overall: treatment group(75.828±7.260)μm,control group(65.037±13.074)μm,RNFL thickness of the nasal quadrant: treatment group(59.077±11.055)μm, control group(48.122±7.385)μm, RNFL thickness of the temporal quadrant: treatment group(61.098±14.832)μm, control group(48.133±17.174)μm, RNFL thickness of the superior quadrant: treatment group(96.263±22.537)μm, control group(85.596±20.472)μm, RNFL thickness of the inferior quadrant: treatment group(94.821±19.693)μm, control group(85.072±23.384)μm. There were statistically significant differences in all Stratus OCT-3 measurement parameters(t=-2.282, P=0.035; t=-2.182, P=0.043; t=-2.589, P=0.019; t=-2.236, P=0.038; t=-2.295, P=0.034).

CONCLUSION: Long-term oral Mecobalamin administration obviously improves the visual field defect and retinal nerve fibers loss in the patients with advanced glaucoma after trabeculectomy.