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1 General aspects (0)   1.1 Epidemiology (2)   1.2 Population genetics (1)   1.3 Pathogenesis (0)   1.4 Quality of life (4)   1.5 Glaucomas as cause of blindness (0)   1.6 Prevention and screening (3) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (0)   2.2 Cornea (3)   2.3 Sclera (0)   2.4 Anterior chamber angle (1)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (10)     2.5.2 Schlemms canal (0)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (1)     2.6.1 Production (0)     2.6.2 Outflow (1)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (2)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (0)   2.9 Ciliary body (0)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (0)   2.13 Retina and retinal nerve fibre layer (12)   2.14 Optic disc (9)   2.15 Optic nerve (4)   2.16 Chiasma and retrochiasmal central nervous system (2)   2.17 Stem cells (0)   2.20 Other (0) 3 Laboratory methods (5)   3.1 Microscopy (0)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (3)   3.4 Molecular genetics (1)     3.4.1 Linkage studies (9)     3.4.2 Gene studies (5)   3.5 Molecular biology incl. 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with intraocular tumors (0)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (0)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (1)       9.4.11.2 Glaucomas in aphakia and pseudophakia (0)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (2)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (0)     9.4.15 Glaucoma in relation to systemic disease (9)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (3) 11 Medical treatment (0)   11.1 General management, indication (9)   11.2 Cholinergic drugs (1)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (5)     11.3.4 Betablocker (10)     11.3.5 Other (0)   11.4 Prostaglandins (28)   11.5 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Without tube implant (4)     12.8.2 With tube implant or other drainage devices (11)     12.8.3 Non-perforating (11)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (9)     12.8.11 Complications, endophthalmitis (10)   12.9 Trabeculotomy, goniotomy (3)   12.10 Cyclodestruction (8)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (1)     12.12.3 Phacoemulsification (5)   12.14 Combined cataract extraction and glaucoma surgery (1)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (3)   12.15 Capsulotomy (1)   12.16 Vitrectomy (1)   12.17 Anesthesia (1)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (2) 15 Miscellaneous (3)

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Abstract #10837 Published in IGR 6-2

Low first postoperative day intraocular pressure as a positive prognostic indicator in deep sclerectomy

Shaarawy T; Flammer J; Smits G; Mermoud A
British Journal of Ophthalmology 2004; 88: 658-61

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AIM: To study the possibility of using intraocular pressure (IOP) in the first postoperative day after sclerectomy as a prognostic indicator. METHODS: Non-randomised prospective trial involving 105 eyes of 105 patients with medically uncontrolled primary and secondary open angle glaucoma. Visual acuity, IOP, and slit lamp examinations were performed before and after surgery at 1 and 7 days, and 1, 3, 6, 9, 12, 18, 24, 30, 36, 48, 54, 60, and 66 months. Visual field examinations were repeated every 6 months. A split point on day 1 IOP of less than or equal to 5 mmHg (61%) versus more than 5 mmHg (39%) was used. The first postoperative day IOP was examined in relation to the need for subsequent Nd:YAG goniopuncture, the subsequent use of postoperative antiglaucoma medications, and as a stratification variable in the Kaplan-Meier analyses. RESULTS: The mean follow up was 43.2 (SD 14.3) months. The mean preoperative IOP was 26.8 (SD 7.7) mmHg; the mean postoperative IOP was 5.1 (3.3) mmHg at day 1 and 11.8 (3.1) mmHg at month 60. Patients with IOP 5 mmHg had significantly fewer Nd:YAG goniopunctures (p = 0.0478). A significant (log rank test 0.0122) improvement for those with IOP 5 mmHg in terms of survival was detected using the most stringent criterion (IOP 15 mmHg with no medications). For patients with first postoperative day IOP 5 mmHg, the median time to failure was 24 months (95% CI: 12 to 30), but for those with an IOP >5 mmHg, the median time to failure was only 6 months (CI 2 to 9). No significant difference in postoperative antiglaucoma medications was observed. CONCLUSION: First postoperative day IOP can be considered to be a significant prognostic indicator in deep sclerectomy.

University Eye Hospital, University of Basel, Switzerland. sharawy@glaucoma-surgery.com

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Classification:

12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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