title: The effect of early posttrabeculectomy intraocular pressure spike in the collaborative initial glaucoma treatment study.
abstract: OBJECTIVE
  To examine effects of early postoperative intraocular pressure (IOP) spike in patients undergoing primary trabeculectomy in the Collaborative Initial Glaucoma Treatment Study.
  
  
  METHODS
  We identified patients with IOP spike ≥5 mm Hg above the baseline IOP on postoperative day 1 and those without IOP increase. The mean deviation (MD), pattern standard deviation (PSD), and corrected PSD of the visual field (VF) were compared at 6 months and years 1, 2, 3, and 5 after surgery, as was the IOP.
  
  
  RESULTS
  Seventeen of 300 patients (5.7%) had IOP spike. After controlling for baseline VF severity in a generalized linear regression model that addressed change in MD, PSD, and corrected PSD, or in a logistic regression model for ≥3 dB of MD change, comparison between the groups revealed no significant difference at all time points examined (P>0.05). Patients with IOP spike had significantly higher mean IOP at years 3 and 5 of follow-up (P≤0.04).
  
  
  CONCLUSIONS
  Among Collaborative Initial Glaucoma Treatment Study patients, early posttrabeculectomy IOP spike ≥5 mm Hg above baseline IOP was not associated with subsequent VF loss, but was associated with significantly higher IOP during long-term follow-up.
authors.affiliation: Department of Ophthalmology, University of Washington, 359608, Seattle, WA 98104-2499, USA. pchen@u.washington.edu
authors.forename: Philip P
authors.initials: PP
authors.lastname: Chen
authors.forename: David C
authors.initials: DC
authors.lastname: Musch
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Niziol
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017889:Exfoliation Syndrome / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications; D014130:Trabeculectomy; D014786:Vision Disorders / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents