Triggerfish Recording of IOP Patterns in Combined HFDS Minimally Invasive Glaucoma and Cataract Surgery: A Prospective Study.

Bojan Pajic,Zeljka Cvejic,Horace Massa,Mirko Resan,Brigitte Pajic-Eggspuehler

doi:10.3390/jcm10163472

Abstract

Background: The aim of the study is to investigate whether the circadian IOP rhythm can be influenced by combined cataract surgery with high frequency deep sclerotomy (HFDS) and whether intraocular pressure (IOP) can be significantly reduced by HFDS. Methods: In our study 10 patients were included, in whom 24 h IOP monitoring was installed before and after HFDS/cataract surgery using a Triggerfish. HFDS is a minimally invasive glaucoma surgery (MIGS). Results: After performed HFDS combined with cataract surgery, the IOP was reduced from 27.7 ± 2.11 mmHg to 14.4 ± 2.59 mmHg, which is highly significant (p < 0.001). The contact lens sensor (CLS) cosinor analysis pre- and postoperatively showed that the circadian rhythm is not influenced by the surgery, i.e., the circadian IOP rhythm did not show significant differences before and after surgery. Conclusions: HFDS combined with cataract surgery is a potent surgical method that can significantly reduce the IOP. However, the circadian rhythm cannot be changed by the surgery. The acrophase remained during the night in all patients.

Highlights

Open angle glaucoma is a multifactorial disease in which different risk factors are involved
The following inclusion criteria were defined for the conduct of the study: diagnosis of open angle glaucoma, documented glaucomatous visual field damage with MD of −3 dB or worse and/or findings at the optic nerve head and/or retinal nerve fiber layer that are representative of glaucoma, stable intraocular pressure (IOP)-lowering treatment for the preceding 4 weeks, older than 18 years at inclusion, not more than six spherical diopters or equivalent and no more than two cylindrical diopters, no surgery within the last three months, and signed informed consent for the investigation
We found that after cataract surgery combined with high frequency deep sclerotomy (HFDS), a minimally invasive glaucoma surgery, we achieved an excellent pressure reduction of 13.3 mmHg

Summary

Introduction

Open angle glaucoma is a multifactorial disease in which different risk factors are involved. There are several ways to treat open-angle glaucoma, the first of which is intraocular pressure (IOP) reduction where progression of the disease is significantly slowed or even kept stable [1,2]. Other important risk factors for glaucoma progression are ocular blood flow and the imbalance between IOP and blood pressure [8,9]. IOP peaks and fluctuations are considered to be other important risk factors [9]. For all these reasons, it is important to achieve a sufficient and significant reduction in IOP, and to consider their behaviour in the circadian cycle

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Discussion

Conclusion