Posture-induced Changes in Intraocular Pressure After Trabeculectomy in Patients With Primary Open-angle Glaucoma

Trabeculectomy can effectively reduce posture-induced changes in intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG).

The purpose of this study was to investigate posture-induced changes in IOP after trabeculectomy in patients with medically uncontrolled POAG.

This was a prospective, consecutive study.

Thirty-seven eyes of 37 patients with POAG were included. IOP was measured before trabeculectomy and 1, 2, 3, and 6 months postoperatively with patients in the sitting position, supine position, and lateral decubitus position (LDP) sequentially using iCare IC200 rebound tonometry. In the LDP, the eye scheduled for trabeculectomy was in the dependent position, the contralateral unoperated eye was a control eye. The central corneal thickness, axial length, and anterior chamber depth were measured using partial coherence interferometry.

In the sitting, supine, and LDP, the IOP was significantly reduced at every time point during the follow-up. Although the posture-induced changes in IOP persisted during the follow-up, the range of IOP changes in the sitting and supine positions, sitting and LDP, and the supine and LDP were significantly reduced after than before trabeculectomy. The central corneal thickness did not change significantly after trabeculectomy.

Trabeculectomy can effectively reduce posture-induced changes in IOP in patients with POAG.