title: Can intraoperative intraocular pressure during primary trabeculectomy predict early postoperative pressure?
abstract: OBJECTIVE
  To study the association of intraoperative intraocular pressure (IOP) at the conclusion of primary trabeculectomy with postoperative IOP on days 1, 7, and 30 and report the ability of intraoperative IOP to predict early postoperative IOP.
  
  
  METHODS
  Prospective, observational, case series. Ninety-seven consecutive patients with primary open-angle or angle-closure glaucoma underwent primary trabeculectomy. The IOP was measured 3 minutes after the closure of scleral flap with a formed anterior chamber. Clinical details and complications were recorded over a 30-day follow-up. The patients were grouped as A (intraoperative IOP≤10.0 mm Hg), B (>10, ≤15.0 mm Hg), and C (>15 mm Hg).
  
  
  RESULTS
  Mean age was 60.8±9.9 years. Forty (41.3%) patients were males. Eighty-two (84.5%) had primary angle-closure glaucoma. Mitomycin-c (MMC) was used in 75 (77.3%) eyes. Mean IOP in group C was significantly higher than group A at all visits (P=0.005, 0.002, and 0.05). Postoperative IOP was associated with intraoperative IOP, age, duration, and dose of MMC in univariable regressions. On multivariable analysis, the intraoperative IOP was associated with postoperative IOP's on day 1 (regression coefficient b=0.24, P=0.039, R(2)=0.24) and day 7 (b=0.47, P<0.001, R=0.42), but not on day 30 (b=0.22, P=0.065, R(2)=0.12). IOP on day 7 was predicted by -8.6+0.47×(intraoperative IOP)+0.27×age-11.7×(dose of MMC in mg/mL). Prediction for day 30=9.8+0.27×(intraoperative IOP).
  
  
  CONCLUSIONS
  In patients undergoing uncomplicated primary trabeculectomy, intraoperative IOP is associated with and may predict early postoperative IOP. Adjusting the IOP during the operation may optimize postoperative IOP.
authors: *Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing †Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong ‡Henan Anyang Eye Hospital, Henan Province §Department of Ophthalmology, Handan 3rd Hospital, Hebei Province, China ∥Queensland Eye Institute, University of Queensland, St Lucia, QLD, Australia.
authors: Shi Song
authors: SS
authors: Rong
authors: Hai Lin
authors: HL
authors: Meng
authors: Su Jie
authors: SJ
authors: Fan
authors: Ning Li
authors: NL
authors: Wang
authors: Yuan Bo
authors: YB
authors: Liang
authors: Yao
authors: Y
authors: Huang
authors: Rui
authors: R
authors: Wang
authors: Yanqing
authors: Y
authors: He
authors: Xinqi
authors: X
authors: Chang
authors: Hong Yu
authors: HY
authors: Cui
authors: Zhi Hong
authors: ZH
authors: Zhang
authors: Si Zhen
authors: SZ
authors: Li
authors: Luo Ru
authors: LR
authors: Liu
authors: Ravi
authors: R
authors: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D011184:Postoperative Period; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery; D013524:Surgical Flaps; D014065:Tonometry, Ocular; D014130:Trabeculectomy; D016896:Treatment Outcome
chemical_list: D016685:Mitomycin