Long-term intraocular pressure fluctuation and visual field progression in glaucoma patients with low intraocular pressure after post-trabeculectomy phacoemulsification.
BACKGROUND
The aim of this study was to evaluate the association of long-term intraocular pressure (IOP) fluctuation and visual field progression in glaucoma patients with low IOP after post-trabeculectomy phacoemulsification.


METHODS
A total of 688 eyes with primary open-angle glaucoma (POAG) and chronic primary angle-closure glaucoma (CPACG) were included in this study. The patients always had an IOP below 18 mmHg after post-trabeculectomy phacoemulsification. Visual field testing using the standard automated perimetry was periodically performed at 3 months and for at least 3 years postoperatively. The mean deviation on visual field was compared according to the standard deviation (SD) of the postoperative IOP (SD < or = 2 mmHg group vs. SD > 2 mmHg group).


RESULTS
Preoperative and postoperative IOPs during the follow-up period did not differ significantly between the two study groups. Even though the mean deviations on visual field at postoperative 3 months were not different between the two groups, the mean deviations at the last follow-up were significantly worse in the postoperative IOP SD > 2 mmHg group than the postoperative IOP SD < or = 2 mmHg group.


CONCLUSIONS
Less postoperative IOP fluctuation was statistically associated with a slower progression of visual field damage in POAG and CPACG patients who kept low IOPs after the post-trabeculectomy phacoemulsification.
Hong
Samin
S
Department of Ophthalmology, Institute of Vision Research, Yongdong Severance Hospital Yonsei University College of Medicine, Seoul, Korea.
Kim
Chan Yun
CY
Seong
Gong Je
GJ
D000368:Aged; D002386:Cataract / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D013995:Time; D014130:Trabeculectomy; D016896:Treatment Outcome; D014794:Visual Fields