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Abstract #21861 Published in IGR 10-3
Medically controlled glaucoma patients show greater increase in intraocular pressure than surgically controlled patients with the water drinking test
Danesh-Meyer HV; Papchenko T; Tan YW; Gamble GDOphthalmology 2008; 115: 1566-1570
PURPOSE: To evaluate whether patients who have undergone trabeculectomy with mitomycin C have a different intraocular pressure (IOP) response profile after the water drinking test (WDT) from that of patients who are medically managed with a similar baseline IOP and level of visual field (VF) damage. DESIGN: Prospective observational study. PARTICIPANTS: Thirty glaucoma patients with IOP controlled by trabeculectomy and 30 with medically treated glaucoma matched for level of VF damage and IOP at baseline (7-14 mmHg). METHODS: All patients underwent the WDT, which involved drinking 1000 ml of water in 15 minutes. MAIN OUTCOME MEASURES: The IOP was measured before the WDT and subsequently at 15-minute intervals for 1 hour. The peak IOP with the WDT was compared between both groups using Tukey post hoc multiple comparison and paired t tests. RESULTS: Baseline IOPs were 10.4 ± 2.3 mmHg in surgically treated and 11.1 ± 1.8 mmHg (P = 0.07) in medically treated eyes. After the WDT, mean IOPs in the surgically and medically treated groups were 10.7 ± 2.3 mmHg and 14.6 ± 2.2 mmHg. Mean maximum IOPs were 11.7 ± 2.6 mmHg and 17.3 ± 2.7 mmHg in the surgically and medically treated groups, respectively (P < 0.0001), increases of 12.5% and 56%. Ranges of IOP during the WDT were 2.2 ± 1.3 mmHg and 5.6 ± 1.9 mmHg in the surgically and medically treated patients (P < 0.0001). CONCLUSIONS: Patients with advanced glaucoma who are medically controlled show greater IOP elevation and peak IOP after the WDT than eyes that have undergone trabeculectomy.
Dr. H.V. Danesch-Meyer, Department of Ophthalmology, University of Auckland, Auckland, New Zealand
Classification:
6.13 Provocative tests (Part of: 6 Clinical examination methods)
11.1 General management, indication (Part of: 11 Medical treatment)
12.1 General management, indication (Part of: 12 Surgical treatment)
