Early Postoperative Intraocular Pressure as a Prognostic Factor in Glaucoma Surgery
DOI:
https://doi.org/10.48560/rspo.28279Keywords:
Glaucoma/surgery, Intraocular Pressure, Postoperative Period, Prognosis, TrabeculectomyAbstract
INTRODUCTION: The relationship between early and late postoperative intraocular pres- sure (IOP) after glaucoma surgery remains unclarified. Few published studies have investigated the long-term effects of early IOP after trabeculectomy and nonpenetrating deep sclerectomy, and the existing ones have differing results. This study aims to evaluate the effects of early postoperative IOP after these two procedures on long-term surgical success rate.
METHODS: We retrospectively studied the patients with open-angle glaucoma who underwent primary trabeculectomy (86 eyes of 72 patients) or primary nonpenetrating deep sclerectomy (137 eyes of 117 patients) between January 2010 and July 2020 that were followed for at least 24 months postoperatively. For each procedure, the study population was divided into three groups according to the IOP registered in the early postoperative time: IOP <6 mmHg, IOP 6-18 mmHg and IOP >18 mmHg. The postoperative IOP, the number of IOP-lowering medications and best corrected visual acuity were compared among the groups. Surgical success was defined as presenting postoperative IOP ≤18 mmHg during medium and long-term follow-up period. Success probability analysis was performed using a Kaplan-Meier survival curve.
RESULTS: Patients with an early IOP >18 mmHg had significantly worse IOP control and success rate in long-term follow-up for both trabeculectomy and nonpenetrating deep sclerectomy. Patients with early transient hypotony after trabeculectomy had a tendency for better long-term surgical outcome.
CONCLUSION: The early postoperative IOP state influences the long-term prognosis after glaucoma surgery.
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