Fluctuations of the Intraocular Pressure in Medically Versus Surgically Treated Glaucoma Patients by a Contact Lens Sensor.

Abstract

To compare fluctuations in intraocular pressure (IOP) in medically vs surgically treated glaucoma patients. Prospective, nonrandomized case series. IOP-related fluctuations were measured for 24 hours using a contact lens sensor (CLS). We performed monitoring with CLS in 91 eyes of 77 patients; 59 eyes were receiving ocular hypotensive medication and had no previous history of glaucoma surgery (medical group), while 32 eyes with open-angle glaucoma (OAG) had previously undergone glaucoma surgery (surgical group). The amplitude, expressed as an indicator of the IOP-related fluctuation, and the presence of a nocturnal acrophase. We also identified maximum and minimum IOP-related values for each patient. The mean (standard deviation) amplitude of IOP-related CLS signal in the group of surgically treated eyes was 100 (41) mV eq, while in the medically treated group it was 131 (69) mV eq (difference: P = .010). We found that 42.9% of the surgically treated but only 13.8% of the medically treated glaucoma group exhibited an absence of nocturnal acrophase (difference: P = .011). The maximum and minimum IOP-related values for the medical group were statistically higher than the surgical group (P = .001 and P = .006, respectively). IOP-related fluctuations were larger in eyes with medically treated glaucoma than in those with surgically treated glaucoma. A significantly larger fraction of the surgical group exhibited an absence of nocturnal acrophase compared to the medically treated group.