Long-term intraocular pressure fluctuation and progressive visual field deterioration in patients with glaucoma and low intraocular pressures after a triple procedure.
OBJECTIVE
To evaluate the association of long-term intraocular pressure (IOP) fluctuation and visual field (VF) progression in patients with glaucoma and low IOP.


METHODS
Four hundred eight eyes with IOPs below 18 mm Hg after a triple procedure (phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy) were included in this study. Measurements of IOP and VF were taken for at least 3 years after surgery. Based on the SD in postoperative IOPs, the sample was split into 2 groups (group 1: SD<or=2; group 2: SD>2). Change in VF at each test location was defined as a change in threshold sensitivity of 1 dB per year or higher, with P<or=.01; pointwise linear regression analysis was applied.


METHODS
Intraocular pressure and VF progression.


RESULTS
The groups showed no differences in IOPs through the follow-up period and in the VF defect score 3 months after surgery. After 13 years, more patients with progressive VF deterioration were detected in group 2 than in group 1.


CONCLUSIONS
Our results showed that larger long-term IOP fluctuation was associated with a progressive increase in the VF deterioration even though patients with glaucoma maintained their IOPs after the triple procedure.


CONCLUSIONS
The SD of long-term IOP should be less than 2 in patients with glaucoma, even if their IOPs drop below 18 mm Hg.


BACKGROUND
clinicaltrials.gov Identifier: NCT00428740.
Hong
Samin
S
Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752 Korea.
Seong
Gong Je
GJ
Hong
Young Jae
YJ
D000368:Aged; D002386:Cataract / Q000503:physiopathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications; D011184:Postoperative Period; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014130:Trabeculectomy; D014794:Visual Fields / Q000502:physiology*