title: A Comparative Study of the Water Drinking Test in Eyes With Open-Angle Glaucoma and Prior Trabeculectomy or Tube Shunt.
abstract: OBJECTIVE
  To compare the intraocular pressure (IOP) response after the water drinking test (WDT) in patients who have undergone trabeculectomy or tube shunt surgery.
  
  
  METHODS
  This prospective study examined 40 eyes of 34 open-angle glaucoma subjects who had undergone trabeculectomy (n=20) or tube shunt surgery (n=20). Both groups were matched by IOP range and by number of topical antiglaucoma medications used. After a baseline IOP assessment, subjects drank 10 mL water per kg body weight over 15 minutes. IOP was then measured with a Goldman tonometer every 15 minutes over a 1-hour period. Outcomes measures were IOP peak, fluctuation, mean, and range.
  
  
  RESULTS
  No significant differences in baseline demographics, baseline clinical characteristics or IOP changes during the WDT were observed between the 2 surgical procedure groups. Mean baseline IOPs for the tube shunt and trabeculectomy groups were 12.55±4.23 and 12.3±4.28 mm Hg, respectively (P=0.854). In the trabeculectomy and tube shunt groups, respectively, peak IOP was 16.25±5.55 and 16.15±5.36 mm Hg (P=0.954); IOP fluctuation (IOP max-IOP baseline) was 3.95±2.17 and 3.6±2.23 mm Hg (P=0.618), and IOP range was 2.78±1.56 and 2.8±1.47 mm Hg (P=0.959). Statistical analysis of IOP fluctuation associations using multivariable linear regression determined that the use of systemic antihypertensive blood pressure medication was associated with an increase in IOP fluctuation of approximately 2 mm Hg.
  
  
  CONCLUSIONS
  Subjects who had undergone either trabeculectomy or tube shunt surgery showed a similar IOP response to the WDT. Subjects on systemic antihypertensive medications experienced significantly greater IOP fluctuations during the test.
authors.affiliation: *Glaucoma Service, Wills Eye Hospital †Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Martinez
authors.forename: Valerie
authors.initials: V
authors.lastname: Trubnik
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Leiby
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hegarty
authors.forename: Reza
authors.initials: R
authors.lastname: Razeghinejad
authors.forename: Shravan
authors.initials: S
authors.lastname: Savant
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Myers
mesh_terms: D000368:Aged; D004326:Drinking / Q000502:physiology*; D005260:Female; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy; D014867:Water / Q000008:administration & dosage*
chemical_list: D014867:Water