title: Long term effect of trabeculectomy on retrobulbar haemodynamics in glaucoma.
abstract: OBJECTIVE
  Previous reports showed increased flow velocities in retrobulbar vessels after glaucoma surgery in the first weeks. Colour Doppler imaging was performed to investigate the long-term effects of trabeculectomy on retrobulbar haemodynamics in patients with primary open-angle glaucoma (POAG).
  
  
  METHODS
  In a prospective study 30 patients (mean age 63.2 ± 15.4 years) with POAG were included. Colour Doppler imaging was performed before 1-2 weeks, after 2 months, after 4-6 months, and up to 3 years after trabeculectomy to determine the peak systolic and end-diastolic velocities in the ophthalmic artery, central retinal artery, and the short nasal and temporal posterior ciliary arteries.
  
  
  RESULTS
  Mean follow-up was 416 ± 246 days. In the first postsurgical period mean intraocular pressure (IOP) decreased after trabeculectomy from 25 ± 6 mmHg to 9 ± 4 mm Hg (p < 0.0001) and then increased in the further follow-up to 13 ± 3 mmHg (p < 0.05) without any anti-glaucomatous medication. Colour Doppler imaging revealed a significant increase of the end-diastolic velocities of the central retinal artery at all postoperative visits compared to pre-surgery (p < 0.003) and of the end-diastolic velocities in the temporal posterior ciliary arteries (p < 0.003). The change of blood flow parameters that increased during follow-up was significantly correlated to the change in ocular perfusion pressure and IOP.
  
  
  CONCLUSIONS
  End-diastolic velocities of the central retinal artery and of the temporal posterior ciliary arteries increased after successful trabeculectomy and remained stable in a longer period - even if IOP rose significantly in the follow-up.
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Kuerten
authors.forename: Matthias
authors.initials: M
authors.lastname: Fuest
authors.forename: Eva C
authors.initials: EC
authors.lastname: Koch
authors.forename: Andreas
authors.initials: A
authors.lastname: Remky
authors.forename: Niklas
authors.initials: N
authors.lastname: Plange
mesh_terms: D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology; D019842:Ciliary Arteries / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000503:physiopathology; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology*; D012161:Retinal Artery / Q000503:physiopathology; D014130:Trabeculectomy / Q000009:adverse effects*; D018615:Ultrasonography, Doppler, Color
keywords: Colour Doppler imaging; glaucoma; ocular blood flow; trabeculectomy