Correlation between Intraocular Pressure Fluctuation with Postural Change and Postoperative Intraocular Pressure in Relation to the Time Course after Trabeculectomy.

Kazuyuki Hirooka,Kaori Tenkumo,Eri Nitta,Shino Sato

doi:10.1155/2014/801967

Abstract

Background. To investigate the correlation between intraocular pressure (IOP) fluctuation with postural change and IOP in relation to the time course after trabeculectomy. Methods. A total of 29 patients who had previously undergone primary trabeculectomy with mitomycin C were examined. IOP was obtained at 1, 2, 3, 6, and 12 months and then every 6 months postoperatively. Results. The postural IOP difference before surgery was 3.0 ± 1.8 mmHg, which was reduced to 0.9 ± 1.1 mmHg at 1 month, 1.0 ± 1.0 mmHg at 2 months, 1.3 ± 2.0 mmHg at 3 months, 1.3 ± 1.4 mmHg at 6 months, 1.4 ± 1.5 mmHg at 12 months, and 1.1 ± 0.7 mmHg at 18 months after trabeculectomy (P < 0.01 each visit). The filtering surgery failed in 7 out of 29 eyes. Postural IOP changes were less than 3 mmHg in those patients who did not require needle revision at every visit. However, in patients who did require needle revision, the increase in the posture-induced IOP was greater than 3 mmHg prior to the increase in the sitting position IOP. Conclusions. Assessment of postural IOP changes after trabeculectomy might be potentially useful for predicting IOP changes after trabeculectomy.

Highlights

Intraocular pressure (IOP) is a major risk factor for the development of glaucoma
In addition to the supine position being an important contributor to the intraocular pressure (IOP) elevation observed at night, this position has been shown to be associated with the progression of open-angle glaucoma [6, 9, 10]
The purpose of the current study was to investigate the correlation between the sitting IOP and the degree of postural IOP changes in relation to the time course after trabeculectomy

Summary

Introduction

Intraocular pressure (IOP) is a major risk factor for the development of glaucoma. Changes in body position have been shown to affect IOP [1,2,3,4,5,6]. When treating glaucoma patients, it is very important to be able to ascertain the IOP changes that occur due to postural changes. To investigate the correlation between intraocular pressure (IOP) fluctuation with postural change and IOP in relation to the time course after trabeculectomy. The postural IOP difference before surgery was 3.0 ± 1.8 mmHg, which was reduced to 0.9 ± 1.1 mmHg at 1 month, 1.0 ± 1.0 mmHg at 2 months, 1.3 ± 2.0 mmHg at 3 months, 1.3 ± 1.4 mmHg at 6 months, 1.4 ± 1.5 mmHg at 12 months, and 1.1 ± 0.7 mmHg at 18 months after trabeculectomy (P < 0.01 each visit). Postural IOP changes were less than 3 mmHg in those patients who did not require needle revision at every visit. In patients who did require needle revision, the increase in the posture-induced IOP was greater than 3 mmHg prior to the increase in the sitting position IOP. Assessment of postural IOP changes after trabeculectomy might be potentially useful for predicting IOP changes after trabeculectomy

Objectives

Methods

Results

Conclusion