Does Surgical Treatment of Obstructive Sleep Apnea Reduce Intraocular Pressure?

Abstract

Abstract: : Purpose: To determine if surgical correction of obstructive sleep apnea (OSA) reduces intraocular pressure. Methods: Patients scheduled for surgical management of OSA were enrolled. OSA was diagnosed by a history of sleep disordered breathing as determined by an Epworth daytime somnolence score greater than 10 as well as a respiratory disturbance index (RDI) greater than 5 during polysomnography. Epworth sleep scales were also administered post-operatively to assess the effectiveness of the surgical procedure in reducing the symptoms of OSA. Each patient underwent complete ophthalmologic examinations before surgery. Goldmann applanation tonometry measurements were taken on four separate visits including two pre-operatively and two 1-3 months after surgery. All IOP measurements were obtained within the same two-hour time period of day to control for normal diurnal fluctuations. Results: Nine patients completed the study with an average RDI of 26.8 (± 22.5). Epworth daytime somnolence scores were significantly reduced from 16.5 ±4.5 before surgery to 6.3 +/-2.8 post-operatively (p < .0002). Mean intraocular pressure readings were also significantly reduced from 17.6 ±4.2 pre-operatively to 16.1 mmHg ±3.1 after surgery (p < .05). Conclusion: Surgical treatment of OSA is associated with an 8.5% reduction in intraocular pressure and should be considered in patients with both OSA and glaucoma. Given the small magnitude of this reduction in IOP however, other mechanisms in addition to IOP likely contribute to the increased prevalence of glaucomatous optic neuropathy seen in patients with OSA.

Keywords: 444 intraocular pressure