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Yuta Saito, Chiaki Yui, Kensaku Yasuda, Eiko Miura, Noriko Yasuda, Haruo Takahashi; Intraocular pressure reduction effects of Ripasudil after Trabectome® surgery. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1230. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Ripasudil ophthalmic solution, which is one of ROCK inhibitors, is considered to act on the trabecular meshwork (TM) and have an effect of promoting conventional aqueous humor outflow. In addition, Trabectome® promotes aqueous outflow to the episcleral veins by ablation of the TM to partially opening of Schlemm’s canal. Hence, the mechanism of intraocular pressure (IOP) reducing between Ripasudil and Trabectome® is overlap. In this study, we investigated the IOP reduction effects by Ripasudil before and after Trabectome® surgery.
Observational study. Nine eyes of 8 patients with primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (EXG) treated with Ripasudil ophthalmic solution suitable for Trabectome® were included. The patients had not previously undergone surgery except for cataract surgery. All surgery was performed from July 2017 to October at Showa University Hospital by one surgeon with Trabectome®. IOP before and after 2 hours treating with Ripasudil 0.4% ophthalmic solution was measured at before surgery, 1 week and 1 month after surgery. After surgery, glaucoma instillation other than Ripasudil was resumed at the discretion of the surgeon. Statistical analyses were performed with paired t test. P value <0.05 was considered significantly.
The relevant data of the study cases is shown in Table 1. Preoperatively, IOP (mmHg) before instillation with Ripasudil was 22.6 ± 6.4, reducing significantly to 20.9 ± 5.5 after 2 hours (p<0.01). IOP before and after instillation was 17.0 ± 5.6, 16.9 ± 5.2 (p = 0.94) at 1 week, and 21.2 ± 8.2, 22.4 ± 9.9 (p = 0.14) at 1 month after surgery, respectively. Number of eye drops was 4.8 ± 0.8 before surgery, reducing to 2.4 ± 1.4 at 1 week and 2.4 ± 1.4 at 1 mouth after surgery, respectively.
The effects of Ripasudil to reduce IOP may attenuate after Trabectome®. However, the number of patients is small, and the IOP value is greatly scattered in this study. More number of cases is needed to evaluate the effect of Ripasudil after Trabectome®.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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