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Akira Sawada, Tetsuya Yamamoto; Postural Intraocular Pressure Changes After Trabeculectomy Over Time. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5089.
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To determine whether trabeculectomy affects the posture-induced changes in the intraocular pressure (IOP) and whether it is maintained for months.
Twenty-nine eyes of 29 patients with open-angle glaucoma who were scheduled for their initial trabeculectomy with adjunctive mitomycin C were subjected. The IOP was measured in the sitting and the lateral decubitus position with an ICare rebound tonometer before, and 1, 3, and 12 months after the surgery.
The mean baseline IOP measured with the ICare was 17.4 ± 4.9 mmHg in the sitting position and 21.3 ± 5.6 mmHg in the lateral decubitus position (P<0.001). This postural IOP difference, +3.8 mmHg, was reduced to +1.3 ± 1.7 mmHg at one month and to +0.8 ± 1.5 mmHg at 3 months after the surgery (P<0.001 and P=0.004, respectively). This decrease in the degree of posture-dependent IOP change was maintained at +1.7 ± 2.2 mmHg at 1-year postoperatively (P<0.001). In 3 cases, the postural IOP changes returned to the baseline level, and all 3 had a failed bleb.
Our results indicate that trabeculectomy not only reduces the IOP but also reduces the degree of posture-induced changes in the IOP. However, even after successful trabeculectomy, a significant difference in the IOP was present between the sitting and the lateral decubitus position.
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