Intraocular Pressure Spikes within First Postoperative Hours following Standard Trabeculectomy: Incidence and Associated Factors

Abstract

Purpose: To evaluate the incidence of intraocular pressure (IOP) spikes within the first postoperative hours following trabeculectomy (TRAB) and to determine possible associated factors. Methods: An observational study was carried out. We enrolled consecutive patients undergoing standard TRAB with mitomycin C. They were examined twice within the first few postoperative hours (hours 1-2 and 4-6) and 3 times after TRAB (on days 1, 7, and 30). Demographic and ocular data were collected. Main outcome measurements were postoperative IOP values at each time point and the frequency of IOP spikes, defined as IOP ≥25 mm Hg. Results: A total of 40 eyes of 40 patients were included (mean age 59.62 ± 13.37 years). Although IOP was significantly reduced to 11.14 ± 7.99 mm Hg at hours 1-2 (p < 0.01) and to 11.52 ± 7.30 mm Hg at hours 4-6 (p < 0.01), IOP spikes were documented in 3 patients (7.5%). In the group of patients with IOP spikes, we noted that there was a high incidence of black patients and that the surgeries had been performed by fellow surgeons. Conclusion: Although the majority of the cases (92.5% of the patients) did not present IOP spikes, 7.5% of our patients presented the event. In selected cases, such as those with advanced disease, fixation threat, and of black race, IOP should be monitored during the first few postoperative hours for the identification and adequate management of potential IOP spikes, preventing undesirable outcomes.

Comparing Vitrectomy, Silicone Oil Endotamponade With/Without Cyclopexy to Treat Cyclodialysis Clefts With Severe Ocular Trauma

“…UBM examinations were usually repeated on postoperative Day 10. Postoperative clinical data including BCVA, IOP, complications such as IOP spikes 8 (IOP ≥ 25 mmHg), hypotony 3 (IOP ≤ 5 mmHg), and secondary glaucoma were collected. Intraocular pressure spikes were treated with antihypertensive therapy.…”

Vitrectomy with Air Endotamponade for Traumatic Cyclodialysis

“…Postoperative examinations were planned for days 1, 2, and 3, week 2, and months 1, 3, 6, and 12. Twelve months after surgery, follow-ups were scheduled annually; during these examinations, clinical follow-up data, including anatomical outcomes, BCVA, IOP, IOP spike (IOP ≥25 mmHg) [ 15 ], and hypotony (IOP≤5 mmHg), were recorded [ 1 ]. Gonioscopy and UBM were performed at least two weeks later postoperatively.…”