title: Ocular massage for intraocular pressure control after Ahmed valve insertion.
abstract: BACKGROUND
  To investigate the immediate and longer-term effect of ocular massage on intraocular pressure (IOP) after Ahmed valve insertion.
  
  
  METHODS
  A retrospective chart review was undertaken of the effects of ocular massage in patients with inadequately controlled IOP after Ahmed valve surgery. During a 20-month period between January 2004 and August 2005, 20 of 52 patients underwent a course of ocular massage. They were compared on IOP and the number of ocular hypotensive medications required with the 32 patients whose IOP was satisfactory after surgery.
  
  
  RESULTS
  The mean time to initiation of massage was 29 days (range 8-141 days), and the mean total duration of massage was 127 days (range 18-273 days). At the initiation of massage, the mean IOP was 19.2 mm Hg, significantly higher than at any other postoperative visit (p = 0.001-0.02). Immediately following massage, the IOP was reduced by 40% to 11.6 mm Hg (p < 0.001). When compared with those patients not requiring massage, there were no differences in IOP at any subsequent visit (p = 0.1-0.9). There were also no differences in final absolute IOP reduction (11.1 [SD 5.9] for the massage group vs. 10.64 [SD 8.0] mm Hg for those not requiring massage, p = 0.8), percentage IOP reduction (46% vs. 40%, p = 0.5), or number of glaucoma medications required at 1 year (2.9 vs. 2.6, p = 0.4), respectively. The massage group was receiving more medications than the group not requiring massage at 3 months (3.1 vs. 1.9) and 6 months (3.5 vs. 2.2). No complications arose due to ocular massage.
  
  
  CONCLUSIONS
  This is the first report to document that ocular massage is a safe and effective manoeuvre for the management of elevated IOP after Ahmed valve insertion. Massage resulted in an immediate reduction of IOP, and, despite initial higher postoperative IOP in the massage group, there were no differences between groups at 1 year with regard to IOP reduction or requirements for medications.
authors.affiliation: Deparmtnet of Ophthalmology, University of Western Ontario, London, Ontario, Canada. imcilraith@hotmail.com
authors.forename: Ian
authors.initials: I
authors.lastname: McIlraith
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Buys
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Campbell
authors.forename: Graham E
authors.initials: GE
authors.lastname: Trope
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage; D001082:Aqueous Humor / Q000378:metabolism*; D005260:Female; D020327:Glaucoma Drainage Implants; D015812:Glaucoma, Angle-Closure / Q000601:surgery; D005902:Glaucoma, Open-Angle / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008405:Massage; D008875:Middle Aged; D009799:Ocular Physiological Phenomena; D011182:Postoperative Care; D019919:Prosthesis Implantation; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents