Department of Ophthalmology, University Hospital Würzburg, Josef-Schneider-Strasse 11, Würzburg, Germany.
Ophthalmologica. 2012;227(3):160-5. doi: 10.1159/000333099. Epub 2011 Nov 10.
The aim of this study was to compare diurnal and nocturnal intraocular pressure (IOP) fluctuations before and after trabeculectomy, and to evaluate the potential of trabeculectomy to even out IOP peaks.
Retrospectively, 35 diurnal and nocturnal IOP curves of patients (35 eyes) who underwent trabeculectomy were analyzed. Diurnal and nocturnal IOP profiles were recorded from 06:00 to 23:59 and 00:00 to 06:00, respectively. Follow-up was at least 300 days. Two criteria for success were defined: (1) IOP ≤21 mm Hg and at least a 20% IOP reduction from baseline; (2) <18 mm Hg without medication.
The preoperative maximum diurnal and nocturnal IOP (IOP(max)) were 26.5 ± 5.9 and 23.4 ± 5.2 mm Hg, respectively. The postoperative diurnal and nocturnal IOP(max) were 16 ± 4.4 and 16 ± 5.4 mm Hg, respectively. Pre- to postoperative IOP reductions were statistically different (day 40% and night 32%; p < 0.001). Diurnal fluctuation was reduced significantly from 12.1 ± 4.2 mm Hg preoperatively to 5.6 ± 2.2 mm Hg postoperatively (reduction of 54%), and nocturnal fluctuation from 7.1 ± 4.5 to 3.9 ± 4.1 mm Hg (reduction of 46%, statistically insignificant due to large SD), respectively. Success criteria 1 and 2 were achieved in 71 and 54% of patients at daytime and in 63 and 57% at nighttime (no statistically significant difference detectable). Follow-up was 2.1 ± 1.7 years.
Trabeculectomy achieves a leveling of IOP(max) in the diurnal-nocturnal comparison. The preoperative fluctuations could be nearly bisected. Relating to the success criteria, the statistical analysis did not reveal a difference in the diurnal-nocturnal comparison.
本研究旨在比较小梁切除术前后的日间和夜间眼压（IOP）波动，并评估小梁切除术使眼压峰值均匀化的潜力。
回顾性分析了 35 例（35 只眼）接受小梁切除术的患者的 35 个日间和夜间 IOP 曲线。日间和夜间 IOP 曲线分别记录为 06:00 至 23:59 和 00:00 至 06:00。随访时间至少 300 天。定义了两种成功标准：（1）IOP≤21mmHg，与基线相比IOP 降低至少 20%；（2）<18mmHg 无需药物治疗。
术前最大日间和夜间 IOP（IOP(max)）分别为 26.5±5.9mmHg 和 23.4±5.2mmHg。术后日间和夜间 IOP(max)分别为 16±4.4mmHg 和 16±5.4mmHg。术前至术后的 IOP 降低差异有统计学意义（日间 40%，夜间 32%；p<0.001）。日间波动从术前的 12.1±4.2mmHg 显著降低至术后的 5.6±2.2mmHg（降低 54%），夜间波动从 7.1±4.5mmHg 降至 3.9±4.1mmHg（降低 46%，由于标准差较大，差异无统计学意义）。日间成功率标准 1 和标准 2分别为 71%和 54%，夜间分别为 63%和 57%（无统计学差异）。随访时间为 2.1±1.7 年。
小梁切除术使日间和夜间的 IOP(max) 达到平衡。术前波动几乎可以减半。根据成功标准，统计学分析并未显示日间和夜间之间的差异。
