Can a contact lens sensor predict the success of trabectome surgery?

Abstract

We examined whether a contact lens sensor (CLS) is useful for the postoperative evaluation of trabectome surgery. We investigated the correlations between the outcomes of trabectome surgery and the output of a CLS. We examined 24 consecutive eyes of patients with pseudo-exfoliation glaucoma. In each eye, the intraocular pressure (IOP) fluctuations over 24h were measured with the SENSIMED Triggerfish CLS before and at 3months after the trabectome surgery. We divided the patients into success (n = 12 eyes) and failure (n = 12 eyes) groups; success was defined as a postoperative IOP level ≤ 21mmHg plus an IOP reduction ≥ 20% relative to the preoperative IOP value with or without anti-glaucoma medications. We investigated CLS parameters that correlate with surgical outcomes by performing a Cox hazard regression analysis. We determined the maximum value, minimum value, and range of IOP fluctuation as CLS parameters. The mean follow-up period was 38.0 ± 3.0months. The success rate was 50%. The postoperative range of IOP fluctuation during the nocturnal period with the CLS was significantly correlated with the surgical results (p = 0.024). A smaller range of IOP fluctuation was significantly correlated with better surgical outcomes. We were able to predict the surgical success after trabectome surgery at 3months using the CLS. Thus, CLS results could be a new surgical evaluation parameter.