title: Ocular digital massage for the management of post- trabeculectomy underfiltering blebs.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of ocular digital massage (ODM) in the management of underfiltering blebs after trabeculectomy.
  
  
  METHODS
  Quasi experimental study.
  
  
  METHODS
  Glaucoma Clinic of Al-Shifa Trust Eye Hospital, Rawalpindi, from January 2007 to November 2008.
  
  
  METHODS
  ODM was performed 3-4 times daily in 20 eyes having intraocular pressure (IOP) above the target level after trabeculectomy. Equal number of eyes with satisfactory IOP after trabeculectomy were taken as controls. Both groups were evaluated at 1 week, 3 weeks, 6 weeks, 3 months, 6 months and 9 months. Mean IOP, frequency of complications and required number of IOP lowering medicines in both groups were compared using 't' test.
  
  
  RESULTS
  Massage group had a significantly higher mean IOP than the control group before the initiation of massage (p < 0.001). After initiating ODM, there were no significant differences in the mean IOP of two groups at 1 week (p = 0.421), 3 weeks (p = 0.073), 6 weeks (p = 0.575), 3 months (p = 0.071), 6 months (p = 0.085) and 9 months (p = 0.369). The difference in terms of required number of IOP lowering medicines (p = 0.075) and complication rates (p = 0.411) was also not significant.
  
  
  CONCLUSIONS
  ODM is an effective method for controlling IOP after trabeculectomy, and thus contributes to long-term surgical success with an acceptable risk / benefit ratio.
authors.affiliation: Department of Ophthalmology, Pakistan Institute of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi. drmahmood_shifa@yahoo.com
authors.forename: Mahmood
authors.initials: M
authors.lastname: Ali
authors.forename: Farah
authors.initials: F
authors.lastname: Akhtar
mesh_terms: D001768:Blister / Q000209:etiology / Q000628:therapy*; D005123:Eye; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D014130:Trabeculectomy / Q000009:adverse effects*; D016896:Treatment Outcome; D014785:Vision, Ocular