Intraocular pressure profiles between ipsilateral surgically and contralateral medically-controlled in primary open angle glaucoma patients

To compare the fluctuating characteristics, mean value and peak value of intraocular pressure (IOP) between medically and surgically controlled eyes in patients with primary open angle glaucoma (POAG) based on a 12-hour daytime diurnal curve (12-DDC) and water drinking test (WDT). Additionally, this study evaluated the consistency of 12-DDC outcomes measured on two separate days.

This was a cross-sectional observational study. Eligible POAG patients with unilateral medically and contralateral surgically controlled IOP via functional augmented trabeculectomy bleb were enrolled. Diurnal IOP was detected every 3h from 8:00 a.m. to 8:00 p.m. over two consecutive days to establish the 12-DDC. The WDT was performed subsequent to the completion of diurnal IOP measurement.

A total of 21 POAG patients were included, with a mean age of 65.5±7.3y, predominantly male (n=17, 81.0%), and of Malay ethnicity (n=13, 61.9%). The medically controlled eyes exhibited significantly greater diurnal IOP fluctuation (4.6±1.7 mm Hg) compared with surgically controlled eyes (3.0±1.5 mm Hg, P=0.005). Similarly, the peak IOP derived from WDT was significantly higher in medically controlled eyes (19.6±4.1 mm Hg) than in surgical counterparts (11.2±3.4 mm Hg, P<0.001). A strong and significant positive correlation was identified between peak IOP values of 12-DDC and WDT. For surgically controlled eyes, 12-DDC measurements obtained on two different days showed excellent consistency at all corresponding time points, with Kappa values ranging from 0.88 to 0.95.

Under the condition of consistent physiological background affecting IOP circadian variation in the same individual, surgically controlled eyes demonstrate a superior IOP profile with lower fluctuation and peak IOP compared with medically controlled eyes in POAG patients.