Immediate postoperative intraocular pressure measurements after trabeculectomy with releasable sutures.
BACKGROUND
To assess the practicality of same-day intraocular pressure (IOP) review following trabeculectomy with releasable sutures. It is a prospective observational case series study.


METHODS
40 eyes of patients undergoing inpatient trabeculectomy for glaucoma optic neuropathy. IOP measurement at 2, 4, 8, 12 and 24 h following trabeculectomy with releasable sutures. Slit-lamp microscopy documenting surgical complications.


RESULTS
Three patients required intervention within the first 24 h and four patients at 24 h because of raised IOP. Investigating pressure outcomes of low (<8 mmHg) and high (>21 mmHg) the sensitivity and specificity of IOP assessments at 2, 4, 8 and 12 h were compared with a 'gold standard' of IOP at 24 h postoperatively. False negative results persist at time periods for low IOP and are absent for high IOP only at 8 h postoperatively. There is a marked change in IOP over the first 24-h period in some patients, both from high to low and from low to high levels.


CONCLUSIONS
Same-day review of trabeculectomy is not a practical proposition as a policy for a unit with present operative techniques. Indeed the finding of transient high pressures during the first 24 h in some cases suggests that in those patients for whom there is concern (mainly those with severe disc cupping at the time of surgery) at least one IOP check during the first 24 h postoperatively may be warranted in addition to the 24-h postoperative check.
Mehta
Jodhbir S
JS
Glaucoma Service, Moorfields Eye Hospital, London, UK. jodmehta@gmail.com
Maurino
Vincenzo
V
Patel
Hemankumar
H
Kirwin
James
J
Murdoch
Ian E
IE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005188:False Negative Reactions; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D032801:Iridectomy; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009901:Optic Nerve Diseases / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013536:Suture Techniques; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*
D016685:Mitomycin; D005472:Fluorouracil