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Abstract #47597 Published in IGR 13-4
Diurnal and Nocturnal Intraocular Pressure Fluctuations after Trabeculectomy
Klink T; Praetorius S; Leippi S; Klink J; Grehn FJOphthalmologica 2011;
See also comment(s) by Tony Realini •
Purpose: The aim of this study was to compare diurnal and nocturnal intraocular pressure (IOP) fluctuations before and after trabeculectomy, and to evaluate the potential of trabeculectomy to even out IOP peaks. Materials and Methods: Retrospectively, 35 diurnal and nocturnal IOP curves of patients (35 eyes) who underwent trabeculectomy were analyzed. Diurnal and nocturnal IOP profiles were recorded from 06:00 to 23:59 and 00:00 to 06:00, respectively. Follow-up was at least 300 days. Two criteria for success were defined: (1) IOP (less-than or equal to)21 mm Hg and at least a 20% IOP reduction from baseline; (2) <18 mm Hg without medication. Results: The preoperative maximum diurnal and nocturnal IOP (IOP(max)) were 26.5 (plus or minus) 5.9 and 23.4 (plus or minus) 5.2 mm Hg, respectively. The postoperative diurnal and nocturnal IOP(max) were 16 (plus or minus) 4.4 and 16 (plus or minus) 5.4 mm Hg, respectively. Pre- to postoperative IOP reductions were statistically different (day 40% and night 32%; p < 0.001). Diurnal fluctuation was reduced significantly from 12.1 (plus or minus) 4.2 mm Hg preoperatively to 5.6 (plus or minus) 2.2 mm Hg postoperatively (reduction of 54%), and nocturnal fluctuation from 7.1 (plus or minus) 4.5 to 3.9 (plus or minus) 4.1 mm Hg (reduction of 46%, statistically insignificant due to large SD), respectively. Success criteria 1 and 2 were achieved in 71 and 54% of patients at daytime and in 63 and 57% at nighttime (no statistically significant difference detectable). Follow-up was 2.1 (plus or minus) 1.7 years. Conclusions: Trabeculectomy achieves a leveling of IOP(max) in the diurnal-nocturnal comparison. The preoperative fluctuations could be nearly bisected. Relating to the success criteria, the statistical analysis did not reveal a difference in the diurnal-nocturnal comparison. Copyright (copyright) 2011 S. Karger AG, Basel.
Department of Ophthalmology, University Hospital Wurzburg, Wurzburg, Germany
Classification:
6.1.2 Fluctuation, circadian rhythms (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
