Rong S.S.,Capital Medical University |
Rong S.S.,Chinese University of Hong Kong |
Meng H.L.,Henan Anyang Eye Hospital |
Fan S.J.,Handan 3rd Hospital |
And 12 more authors.
Journal of Glaucoma | Year: 2014
Purpose: To study the association of intraoperative intraocular pressure (IOP) at the conclusion of primary trabeculectomy with postoperative IOP on days 1, 7, and 30 and report the ability of intraoperative IOP to predict early postoperative IOP.Patients andMethods: Prospective, observational, case series. Ninetyseven consecutive patients with primary open-angle or angle-closure glaucoma underwent primary trabeculectomy. The IOP was measured 3 minutes after the closure of scleral flap with a formed anterior chamber. Clinical details and complications were recorded over a 30-day follow-up. The patients were grouped as A (intraoperative IOP≤10.0mm Hg), B (>10, ≤15.0mm Hg), and C (>15mm Hg).Results: Mean age was 60.8±9.9 years. Forty (41.3%) patients were males. Eighty-two (84.5%) had primary angle-closure glaucoma. Mitomycin-c (MMC) was used in 75 (77.3%) eyes. Mean IOP in group C was significantly higher than group A at all visits (P=0.005, 0.002, and 0.05). Postoperative IOP was associated with intraoperative IOP, age, duration, and dose of MMC in univariable regressions. On multivariable analysis, the intraoperative IOP was associated with postoperative IOP's on day 1 (regression coefficient b=0.24, P=0.039, R2=0.24) and day 7 (b=0.47, P<0.001, R2=0.42), but not on day 30 (b=0.22, P=0.065, R2=0.12). IOP on day 7 was predicted by -8.6+0.47× (intraoperative IOP)+0.27×age-11.7×(dose of MMC in mg/mL). Prediction for day 30=9.8+0.27×(intraoperative IOP).Conclusions: In patients undergoing uncomplicated primary trabeculectomy, intraoperative IOP is associated with and may predict early postoperative IOP. Adjusting the IOP during the operation may optimize postoperative IOP. Copyright © 2013 by Lippincott Williams & Wilkins.