Comparison of Posture-Induced Intraocular Pressure Changes in Medically Treated and Surgically Treated Eyes With Open-Angle Glaucoma

Sawada, Akira; Yamamoto, Tetsuya

doi:10.1167/iovs.13-13030

Cited by 20 publications

(15 citation statements)

References 38 publications

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“…It has also been reported that eyes with glaucoma that had undergone trabeculectomy showed less diurnal IOP fluctuation than eyes with medically treated glaucoma [ 27 , 28 ] and that trabeculectomy reduced the degree of posture-induced IOP changes in OAG. [ 29 – 33 ] Sawada et al [ 31 ] reported that eyes with successfully trabeculectomized OAG showed smaller posture-induced IOP changes than eyes with non-operated, medically treated OAG, despite the mean IOP in both groups being the same (9.7 mmHg). Given that trabeculectomy creates a new aqueous pathway via the filtering bleb that is independent of the episcleral veins, it seems reasonable that the surgery could cause suppression of posture-induced IOP alterations.…”

Section: Discussionmentioning

confidence: 99%

Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg

et al. 2017

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We examined the effectiveness of trabeculectomy in decreasing the slope of mean deviation (MD) in Japanese patients with progressive normal-tension glaucoma (NTG) at low intraocular pressure (IOP) levels. The charts of patients who had undergone initial trabeculectomy with adjunctive mitomycin C for progressive NTG with medically controlled IOP < 15 mmHg in 2010–2013 were retrospectively reviewed. Seventeen eyes of 13 NTG patients who had undergone at least 5 times of visual field (VF) examinations in both of preoperatively and postoperatively with postoperative follow-up of ≥ 2 years were enrolled. Preoperative and postoperative MD slopes were compared to evaluate the effectiveness of trabeculectomy in slowing progression of VF. Mean IOP (8.1 ± 2.9 mmHg) and number of IOP-lowering medications (0.8 ± 1.5) were significantly lower postoperatively than preoperatively (13.9 ± 0.9 mmHg; P < 0.001 and 3.0± 0.4; P < 0.0001). In total, 91.7% of eyes with single-digit IOP postoperatively showed improvement in MD slope, whereas only 20.0% of eyes with IOP ≥ 10 mmHg postoperatively showed the improvement. Three eyes (17.6%) showed a decrease in visual acuity (VA) of ≥ 0.1 unit; this group had a lower mean postoperative IOP (6.0 ± 1.0 vs. 8.6 ± 3.0 mmHg; P = 0.1717) and a higher mean IOP reduction rate (56.2 vs. 38.5%; P = 0.8296) than eyes with a VA decrease of < 0.1 unit or no change. Thus, in this analysis of Japanese NTG patients with medically controlled IOP < 15 mmHg, achieving an IOP < 10 mmHg with trabeculectomy was beneficial for reducing the VF progression rate in progressive NTG at low IOP levels. However, an IOP < 7 mmHg by surgery would be required careful attention to VA decline.

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Section: Discussionmentioning

confidence: 99%

Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg

et al. 2017

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“…Previous studies evaluating postural IOP changes have primarily focused on open-angle glaucoma 5,7,10–12 , whereas few have examined postural IOP changes in PACG patients. Sawada and Yamamoto 13 compared OAG and PAC eyes and reported no correlation between postural IOP change and axial length.…”

Section: Discussionmentioning

confidence: 99%

Cataract surgery reduces intraocular pressure but not posture-induced intraocular pressure changes in patients with angle-closure glaucoma

Chang

Wang

Weng

et al. 2019

Sci Rep

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Cataract surgery leads to a sustained decrease in sitting intraocular pressure (IOP) in patients with angle-closure glaucoma (ACG). The purpose of this study is to evaluate whether cataract surgery can also reduce postural IOP changes. We prospectively examined 106 eyes from 53 patients with narrow angles scheduled for phacoemulsification. IOP was measured in the sitting, supine, and lateral decubitus positions using an ICare rebound tonometer before and 1 week, 1 month, and 3 months postoperatively. The mean baseline IOP in the sitting and lateral decubitus positions was 17.9 ± 4.8 mmHg and 21.43 ± 6.44 mmHg, which significantly reduced to 13.52 ± 3.8 and 17.46 ± 3.62, respectively, 3 month postoperatively (p < 0.001). However, postural IOP change (lateral decubitus minus sitting) at 3 months postoperatively was not significantly different from that at the baseline (3.17 ± 2.63 vs. 3.53 ± 3.38 mmHg, p = 0.85). Postural IOP change was not associated with preoperative sitting IOP, anterior chamber depth, axial length, fixed pupil, or presence of glaucomatous optic neuropathy. Patients with higher preoperative IOP exhibited greater IOP reduction after cataract surgery in every posture (p < 0.0001). In conclusion, cataract surgery reduces IOP in all postures among patients with ACG; however, it does not reduce the magnitude of postural IOP change.

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“…Dies wirkt sich direkt auf die therapeutischen Strategien in der Glaukombehandlung aus. Liegendspitzenerscheinendurcheine medikamentös topische Drucksenkung schlecht adressierbar [55]. Auch nach Kataraktoperation wurde zwar eine Reduktion des IOD im Sitzen, nicht jedoch des lageabhängigen Druckanstiegs nachgewiesen [56].…”

Section: Therapeutische Strategienunclassified

“…Auch nach Kataraktoperation wurde zwar eine Reduktion des IOD im Sitzen, nicht jedoch des lageabhängigen Druckanstiegs nachgewiesen [56]. Bei Erkrankungsprogression und signi-fikanten IOD-Spitzen im Liegen sollte die Indikation zur filtrierenden Glaukomchirurgie erwogen werden [55]. Als Grund für die Überlegenheit der filtrierenden Verfahren zur Therapie von Liegendspitzen kann vermutet werden, dass nur bei der Ableitung des Kammerwassers unter die Bindehaut der venöse Widerstand der episkleralen Venen ausgeschaltet wird.…”

Section: Therapeutische Strategienunclassified

Lageabhängigkeit des Augeninnendruckes bei Glaukompatienten

et al. 2020

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Comparison of Posture-Induced Intraocular Pressure Changes in Medically Treated and Surgically Treated Eyes With Open-Angle Glaucoma

Abstract: The lower posture-induced IOP change in the successfully trabeculectomized eyes indicates that trabeculectomy will not only lead to a decrease in the IOP but also lower the posture-induced IOP change.

Cited by 20 publications

References 38 publications

Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg

Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg

Cataract surgery reduces intraocular pressure but not posture-induced intraocular pressure changes in patients with angle-closure glaucoma

Lageabhängigkeit des Augeninnendruckes bei Glaukompatienten

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