Eye Clinic, DiNOGMI, University of Genoa.
Edward S. Harkness Eye Institute, Columbia University Irving Medical Center.
J Glaucoma. 2019 Mar;28(3):252-257. doi: 10.1097/IJG.0000000000001185.
PRéCIS:: The 24-hour ocular dimensional profile recorded by a contact lens sensor was affected by intraocular pressure lowering interventions. Among different treatments, incisional surgery had the most significant effect.
We investigated the effect of different intraocular pressure (IOP)-lowering interventions on contact lens sensor (CLS) parameters and their relationship with Goldmann applanation tonometry (GAT)-measured IOP reduction.
Data from reliable CLS recordings performed before and after IOP-lowering interventions were analyzed. Three interventions were evaluated: topical medications, laser trabeculoplasty, and incisional surgery. A set of 115 different CLS parameters were derived from 24-hour curves. We compared before versus after values for each parameter. In addition, linear regression was performed using the percentage change of each CLS parameter as the outcome variable and the type of IOP-lowering procedure as the predictor after adjusting age and race. Finally, we investigated the relationship between changes in CLS parameters and GAT IOP with the Spearman rank correlation coefficient.
A total of 182 eyes of 182 patients were included in the analyses: 60 (33%) topical medications, 69 (38%) laser, and 53 (29%) surgery. The mean GAT IOP change was 3.6±6.5 mm Hg (P<0.001). Overall, more CLS parameters had a significant change after surgery than in the other groups (surgery>laser=drug). Linear regression showed that, for 20 CLS parameters, surgery was the most predictive of greatest percentage change in CLS signals. In all, 11 (9.5%) of the CLS parameters were significantly correlated with GAT changes.
Incisional glaucoma surgery had a more pronounced effect on GAT and CLS parameters than laser and drugs. The CLS can detect changes in patterns resulting from IOP-lowering interventions beyond daytime GAT IOP. This device could potentially be used to assess treatment efficacy in glaucoma.
目的：我们旨在探究不同的降眼压干预措施对接触镜传感器（CLS）参数的影响，以及这些参数与压平眼压计（GAT）测量的眼压降低之间的关系。
方法：分析了降眼压干预措施前后可靠的 CLS 记录数据。评估了三种干预措施：局部药物治疗、激光小梁成形术和手术。从 24 小时曲线中得出了一组 115 个不同的 CLS 参数。我们比较了每个参数的前后值。此外，在调整年龄和种族后，使用每个 CLS 参数的百分比变化作为因变量，将眼压降低程序的类型作为预测因子进行线性回归。最后，我们用 Spearman 秩相关系数来研究 CLS 参数变化与 GAT 眼压之间的关系。
结果：共纳入 182 名患者的 182 只眼：60 只眼（33%）接受局部药物治疗，69 只眼（38%）接受激光治疗，53 只眼（29%）接受手术治疗。GAT 眼压的平均变化为 3.6±6.5mmHg（P<0.001）。总体而言，手术后 CLS 参数的变化比其他两组（手术>激光>药物）更为显著。线性回归显示，20 个 CLS 参数中，手术是预测 CLS 信号最大百分比变化的最具预测性因素。在所有参数中，有 11 个（9.5%）与 GAT 变化显著相关。
结论：与激光和药物治疗相比，开角型青光眼手术对 GAT 和 CLS 参数的影响更为显著。CLS 可以检测到眼压降低干预措施导致的模式变化，超出了白天 GAT 眼压的范围。该设备有可能用于评估青光眼的治疗效果。
