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Early intraocular pressure rise after trabeculectomy
J M Liebmann1, R Ritch, M DiSclafani
1Department of Ophthalmology, The New York Eye and Ear Infirmary, NY 10003.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|November 1, 1990
Summary
Hyaluronate use after trabeculectomy surgery may increase intraocular pressure (IOP) and risk vision loss. Early IOP monitoring is recommended, and routine hyaluronate use should be avoided in glaucoma patients.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Ocular Hypertension
Background:
- Trabeculectomy is a common surgical procedure for glaucoma.
- Maintaining anterior chamber depth post-surgery is crucial.
- Elevated intraocular pressure (IOP) is a risk factor for glaucomatous damage.
Purpose of the Study:
- To investigate the impact of anterior chamber reformation methods on early postoperative intraocular pressure (IOP) after trabeculectomy.
- To identify factors associated with a significant postoperative IOP rise.
Main Methods:
- Prospective study of 35 patients undergoing initial trabeculectomy.
- Comparison of IOP in eyes where anterior chamber was reformed with balanced salt solution versus hyaluronate sodium.
- IOP measurement at 4-6 hours and 1 day post-surgery.
Main Results:
- Six eyes (17%) experienced IOP ≥ 40 mm Hg at 4-6 hours post-surgery.
- Patients receiving hyaluronate had a significantly higher risk of marked IOP rise at both measured time points (P=.005 and P=.0038).
- No correlation found between IOP rise and patient age, sex, glaucoma type, pre-op IOP, 5-FU use, or suture count.
Conclusions:
- Hyaluronate sodium may contribute to early postoperative IOP elevation after trabeculectomy.
- This IOP rise could potentially lead to further visual field loss in severe glaucoma.
- Recommend close IOP monitoring post-trabeculectomy and judicious use of hyaluronate.