Usefulness of Intraocular Pressure With the Ocular Response Analyzer to Predict Postoperative Hypotony Complications in Glaucoma.

PURPOSE

To investigate the usefulness of intraocular pressure (IOP) using the ocular response analyzer to predict the occurrence of hypotony complications following trabeculectomy or bleb needling revision with mitomycin C.

METHODS

This study included 66 eyes of 66 patients who underwent trabeculectomy (58 eyes of 58 patients) or bleb needling (8 eyes of 8 patients) with mitomycin C. A significant predictor of hypotony complications was identified from (1) operation (trabeculectomy or bleb needling), (2) age, (3) sex, (4) disease type (primary open-angle glaucoma, primary angle closure glaucoma, or exfoliation glaucoma), (5) lens status (phakia or pseudophakia), (6) preoperative Goldmann applanation tonometry IOP, (7) preoperative central corneal thickness, (8) preoperative axial length, (9) preoperative anterior chamber depth, (10) preoperative corneal hysteresis, (11) preoperative corneal resistance factor, (12) preoperative corneal compensated IOP (IOPcc), and (13) minimum IOP (IOP value when hypotony complications occurred, otherwise the minimum IOP during 3 months from trabeculectomy or bleb needling) using multivariate logistic regression.

RESULTS

The probability of the occurrence of hypotony complications tended to increase by applying higher cutoff values to preoperative Goldmann applanation tonometry IOP and IOPcc, but not lower cutoff values to the minimum IOP. Multivariate logistic regression suggested that higher preoperative IOPcc and pseudophakia were significant predictors of the occurrence of hypotony complications (P = 0.0062 and 0.0069, respectively).

CONCLUSIONS

Higher preoperative IOPcc and pseudophakia were significant predictors of the occurrence of hypotony complications.

TRANSLATIONAL RELEVANCE

It is useful to measure IOP using the ocular response analyzer before trabeculectomy.