This article is more than 5 years old. Information may no longer be current.
Drop in ocular pulse amplitude after trab shows good prognosis for long-term control
Click Here to Manage Email Alerts
An initial drop in ocular pulse amplitude of more than 2 mm Hg in eyes that have undergone trabeculectomy is a good prognostic indicator for long-term IOP control, according to a Swiss study.
Sandra R. von Schulthess and colleagues at the University of Zurich investigated the changes in ocular pulse amplitude (OPA) after trabeculectomy in 14 patients with medically uncontrolled primary open-angle glaucoma or pseudoexfoliation glaucoma. The patients ranged in age from 26 to 84 years.
OPA is the difference between the minimum and maximum values of the pulsatile IOP wave contour, according to the study authors.
OPA and IOP were measured at 1 day preop and at intervals up to 3 months after trabeculectomy. The OPA of the contralateral eye was used as a control. Success was defined as a persistent drop in IOP of at least 20%.
Five patients in the study had entirely successful outcomes. On the first day after surgery, OPA decreased in 12 patients and increased in two compared with preop measurements. In surgeries with a long-term successful outcome, the OPA dropped by an average 3.38 mm Hg, while in those who required additional treatments the OPA dropped an average of 0.61 mm Hg. IOP decreased by a mean of 13.1 mm Hg in the successful treatment group and by 5.84 mm Hg in the additional treatment group.
Kaplan-Meier survival analysis showed that patients with an initial drop in OPA of more than 2 mm Hg had a significantly better chance of uncomplicated outcome at 3 months than those with an initial OPA drop of less than 2 mm Hg.
The study is published in the January issue of Graefe’s Archive for Clinical and Experimental Ophthalmology.