May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
The Effect of Early Postoperative IOP Spike on Visual Field Progression in the CIGTS
Author Affiliations & Notes
  • P. P. Chen
    Ophthalmology, University of Washington, Seattle, Washington
  • D. C. Musch
    Ophthalmology, University of Michigan, Ann Arbor, Michigan
  • L. M. Niziol
    Ophthalmology, University of Michigan, Ann Arbor, Michigan
  • CIGTS Study Group
    Ophthalmology, University of Washington, Seattle, Washington
  • Footnotes
    Commercial Relationships  P.P. Chen, None; D.C. Musch, AqueSys, Inc., Glaukos Corp., Occulogix Inc., C; L.M. Niziol, None.
  • Footnotes
    Support  NIH Grants EY09148 & EY015860
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 1590. doi:https://doi.org/
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      P. P. Chen, D. C. Musch, L. M. Niziol, CIGTS Study Group; The Effect of Early Postoperative IOP Spike on Visual Field Progression in the CIGTS. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1590. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To examine the effect of early postoperative intraocular pressure (IOP) spike on subsequent visual field (VF) loss in 300 subjects undergoing primary trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS).

Methods: : CIGTS participants who had an IOP spike of 5 mm Hg or greater above the baseline IOP level on postoperative day 1 were identified, as were those who had no increase in IOP on postoperative day 1 after trabeculectomy. The Mean Deviation (MD) of the Humphrey 24-2 visual field test was compared at 6 months and at years 1, 2, 3, and 5 after enrollment.

Results: : Eighteen patients (6%) had an IOP spike of 5 mm Hg or more. Patients with IOP spike were more likely to be African-American (11/18 vs. 91/262, P = .04). Using a generalized linear regression model for predicting VF change from baseline measured continuously, and controlling for baseline VF severity, at each time point examined no associations with postoperative day 1 IOP were found (P = 0.22 or higher). Similar findings were obtained using a logistic regression model for predicting VF change from baseline measured as less than 3 dB vs. 3 dB or more (P = 0.54 or higher). See Table below for t-test comparison of VF MD between groups. Subsequent procedures performed included ALT (5 patients), cataract extraction (4 patients), bleb revision (4 patients), and repeat trabeculectomy (2 patients). A total of 7 patients (39%) underwent further interventions for IOP above target level, which was not significantly different from the cohort without IOP spike.

Clinical Trial: : www.clinicaltrials.gov nct 00000149

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • visual fields • intraocular pressure 
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