Fluctuations of the Intraocular Pressure in Medically Versus Surgically Treated Glaucoma Patients by a Contact Lens Sensor

Am J Ophthalmol. 2019 Jul:203:1-11. doi: 10.1016/j.ajo.2019.02.003. Epub 2019 Feb 14.

Abstract

Purpose: To compare fluctuations in intraocular pressure (IOP) in medically vs surgically treated glaucoma patients.

Design: Prospective, nonrandomized case series.

Methods: IOP-related fluctuations were measured for 24 hours using a contact lens sensor (CLS).

Subjects: We performed monitoring with CLS in 91 eyes of 77 patients; 59 eyes were receiving ocular hypotensive medication and had no previous history of glaucoma surgery (medical group), while 32 eyes with open-angle glaucoma (OAG) had previously undergone glaucoma surgery (surgical group).

Main outcome measures: The amplitude, expressed as an indicator of the IOP-related fluctuation, and the presence of a nocturnal acrophase. We also identified maximum and minimum IOP-related values for each patient.

Results: The mean (standard deviation) amplitude of IOP-related CLS signal in the group of surgically treated eyes was 100 (41) mV eq, while in the medically treated group it was 131 (69) mV eq (difference: P = .010). We found that 42.9% of the surgically treated but only 13.8% of the medically treated glaucoma group exhibited an absence of nocturnal acrophase (difference: P = .011). The maximum and minimum IOP-related values for the medical group were statistically higher than the surgical group (P = .001 and P = .006, respectively).

Conclusions: IOP-related fluctuations were larger in eyes with medically treated glaucoma than in those with surgically treated glaucoma. A significantly larger fraction of the surgical group exhibited an absence of nocturnal acrophase compared to the medically treated group.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Circadian Rhythm / physiology*
  • Contact Lenses*
  • Equipment Design
  • Female
  • Filtering Surgery / methods*
  • Follow-Up Studies
  • Glaucoma / physiopathology
  • Glaucoma / therapy*
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Monitoring, Physiologic / instrumentation
  • Prospective Studies
  • Tonometry, Ocular / instrumentation*
  • Visual Fields / physiology

Substances

  • Antihypertensive Agents