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Abstract #19536 Published in IGR 9-3
Long-term intraocular pressure fluctuation and progressive visual field deterioration in patients with glaucoma and low intraocular pressures after a triple procedure
Hong S; Seong GJ; Hong YJArchives of Ophthalmology 2007; 125: 1010-1013
See also comment(s) by Kouros Nouri-Mahdavi •
OBJECTIVE: To evaluate the association of long-term intraocular pressure (IOP) fluctuation and visual field (VF) progression in patients with glaucoma and low IOP. METHODS: Four hundred eight eyes with IOPs below 18 mmHg after a triple procedure (phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy) were included in this study. Measurements of IOP and VF were taken for at least 3 years after surgery. Based on the SD in postoperative IOPs, the sample was split into 2 groups (group 1: SD ≤ 2; group 2: SD > 2). Change in VF at each test location was defined as a change in threshold sensitivity of 1 dB per year or higher, with P ≤ .01; pointwise linear regression analysis was applied. MAIN OUTCOME MEASURES: Intraocular pressure and VF progression. RESULTS: The groups showed no differences in IOPs through the follow-up period and in the VF defect score 3 months after surgery. After 13 years, more patients with progressive VF deterioration were detected in group 2 than in group 1. CONCLUSION: Our results showed that larger long-term IOP fluctuation was associated with a progressive increase in the VF deterioration even though patients with glaucoma maintained their IOPs after the triple procedure. APPLICATION TO CLINICAL PRACTICE: The SD of long-term IOP should be less than 2 in patients with glaucoma, even if their IOPs drop below 18 mmHg. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00428740.
Dr. S. Hong, Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752 Korea
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
6.1.2 Fluctuation, circadian rhythms (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
13.2.2.1 Progression (Part of: 13 Therapeutic prognosis and outcome > 13.2 Outcome > 13.2.2 Visual field)