Follow-up of argon laser trabeculoplasty: is a day-one postoperative IOP check necessary?
OBJECTIVE
To evaluate the benefit of measuring the intraocular pressure (IOP) on the first postoperative day after argon laser trabeculoplasty (ALT).


METHODS
We retrospectively reviewed 407 ALT procedures with perioperative apraclonidine performed on 226 patients between January 1991 and December 1993. Data analyzed included type of glaucoma, extent of treatment, whether the procedure was initial or repeat, laser parameters, and IOP preoperatively and at 1 hour, 1 day, and 1 month postoperatively.


RESULTS
The percentage of patients with an IOP rise of greater than 3 mm Hg at 1 hour, 1 day, and 1 month following ALT was 11.3%, 4.2%, and 5.2% respectively. The incidence of IOP elevations greater than 10 mm Hg was 2.2%, 1.0%, and 1.5% at 1 hour, 1 day and 1 month, respectively. Of 17 cases with an IOP elevation greater than 3 mm Hg at 1 day, four eventually required a trabeculectomy. However, there were no consistent factors that distinguished which cases with elevated IOP at 1 day ultimately needed further therapy, nor did the 1-day postoperative examination predict which patients would have IOP elevation at 1 month.


CONCLUSIONS
IOP 1 day after ALT is rarely elevated and does not correlate with IOP elevation at 1 month. Therefore, an IOP check at 1 day is not felt to be necessary for most patients.
Mittra
R A
RA
Duke University Eye Center, Durham, NC 27710, USA.
Allingham
R R
RR
Shields
M B
MB
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D003000:Clonidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D011182:Postoperative Care; D012189:Retrospective Studies; D014130:Trabeculectomy
D000316:Adrenergic alpha-Agonists; C016986:apraclonidine; D003000:Clonidine