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A. Remky, M. Kaup, A. Weber, N. Plange; Effects of Trabeculectomy on Retrobulbar Hemodynamics in Glaucoma Patients . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4794.
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Color Doppler imaging was performed to investigate the effect of trabeculectomy on retrobulbar hemodynamics in patients with primary open–angle glaucoma (POAG).
In a prospective study 20 consecutive patients (age 26 – 83 yrs.; 8 f, 12 m) with POAG were included. Color Doppler imaging (Siemens Sonoline Sienna) was performed before, 1–2 weeks and 2 months after trabeculectomy to determine the peak systolic (PSV) and end–diastolic velocities (EDV) in the ophthalmic artery (OA), central retinal artery (CRA), and the short nasal (NPCA) and temporal (TPCA) ciliary arteries.
1–2 weeks after trabeculectomy intraocular pressure was lowered from 26 ± 6 mm Hg to 9 ± 5 mm Hg without anti–glaucomatous medication. Color Doppler imaging revealed a significant acceleration of the EDV of the central artery 1–2 weeks postoperatively compared to pre–op (pre–op: 1.85 ± 0.45cm/s; post–op: 2.21 ± 0.35cm/s; p = 0.025). Furthermore, EDV of the NPCA (pre–op: 2.14 ± 0.37cm/s; post–op: 2.61 ± 0.74cm/s; p = 0.012) and the EDV of the TPCA (pre–op: 2.11 ± 0.48cm/s; post–op: 2.74 ± 0.54cm/s; p = 0.0003) significantly increased compared to pre–op measurements. After two months these data including IOP (11± 4 mmHg) did not change significantly compared to the data assessed after 1–2 weeks after surgery.
End–diastolic velocities of the central artery and the short posterior ciliary arteries increased after successful trabeculectomy. Follow–up studies have to elucidate the prognostic value of CDI parameters for glaucoma progression compared to IOP reduction solely.
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