Is Intraocular Pressure in the Early Postoperative Period Predictive of Antimetabolite-Augmented Filtration Surgery Success?

Abstract

Intraocular pressure in the early postoperative period correlates very poorly with intraocular pressure one year after successful antimetabolite-augmented trabeculectomy or combined cataract extraction and trabeculectomy. Starting one month after glaucoma surgery, intraocular pressure is substantially lower in eyes that will ultimately not require the use of ocular hypotensive agents to achieve clinical success one year postoperatively.

Can early postoperative intraocular pressure predict success following mitomycin-C augmented trabeculectomy in primary angle-closure glaucoma

“…They felt that IOP at the 1-month point is a better indicator for the long-term course and further intervention. 15 Although this study pooled data from trabeculectomy as well as combined surgery, and postoperative interventions were not considered in the analysis. 15 Manipulation of releasable sutures is believed to substantially affect the filtering pathway.…”

“…15 Although this study pooled data from trabeculectomy as well as combined surgery, and postoperative interventions were not considered in the analysis. 15 Manipulation of releasable sutures is believed to substantially affect the filtering pathway. In RS arm, IOPs started showing correlations with final IOP only after 30 days of time (98.9% of eyes completely removed the sutures).…”

“…Lower initial IOP and the measures used to achieve them are not without risk and giving our inability to lower IOP predictably, striving for very low IOPs might not be advantageous. 15 A balance must be sought between the risks of inducing hypotony and ensuing complications and the attainment of a safe IOP facilitating long-term successful surgery. 10 Analysis of factors contributing to postoperative complication is limited in this study because of a relatively low incidence.…”

“…14 On the contrary, others have reported only a weak association between early and final IOPs and conclude that early postoperative IOPs had limited ability to predict long-term outcomes. 15,16 Until now, the relationship between early and late postoperative IOP was not clarified. We need studies with reasonable sample size and adequate duration of follow-up to conclude the predictive value of early IOP.…”

E-PTFE (Gore-Tex®) implant with or without low-dosage mitomycin-C as an adjuvant in penetrating glaucoma surgery: 2 year randomized clinical trial

“…This finding could indicate a sort of modulation of the aqueous outflow provided by the ePTFE barrier, through its small holes and along its surface, as postulated in the Introduction. This barrier effect could be of benefit, because a heavy early IOP reduction is correlated with more hypotony-related complications, and has been shown to be very poorly correlated to 1 year IOP control in antimetabolite-augmented trabeculectomy (Polikoff et al 2005).…”