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Glaucoma Progression Affected by Pressure Fluctuations

Deterioration happens even after intraocular pressure is reduced with triple surgical procedure

WEDNESDAY, Aug. 15 (HealthDay News) -- In patients with glaucoma, long-term intraocular pressure fluctuations affect the progression of visual field deterioration, even in patients whose intraocular pressure is low (18 mm Hg or less) after undergoing surgery, according to a report published in the August issue of the Archives of Ophthalmology.

Young Jae Hong, M.D., Ph.D., of Yonsei University College of Medicine in Seoul, Korea, and colleagues conducted a study of 408 eyes of 408 patients, including 246 eyes with primary open-angle glaucoma and 162 eyes with chronic primary angle-closure glaucoma.

The subjects underwent a triple procedure: phacoemulsification, foldable posterior chamber intraocular lens implantation, and trabeculectomy. The patients were then split into two groups, with group 1 comprising those with a postoperative intraocular pressure standard deviation of two or less and group 2 including patients with standard deviation of greater than two.

There was no difference in intraocular pressure readings through the follow-up period and the visual defect scores were the same three months after surgery. Group 2 patients had higher incidence of visual field deterioration after 13 years of follow-up compared with group 1 patients.

"Our study suggests that reducing the long-term fluctuation of intraocular pressure after glaucoma surgery is effective in slowing or preventing visual field loss in patients with glaucoma," the authors conclude.

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