Fluctuations of the intraocular pressure in medically versus surgically treated glaucoma patients by a contact lens sensor.

PURPOSE: To compare fluctuations in intraocular pressure (IOP) in medically versus surgically treated glaucoma patients.

DESIGN: Prospective, non-randomized case series.

METHODS: IOP-related fluctuations were measured for 24 hours using a contact lens sensor (CLS).

SUBJECTS: We perform 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).

MAIN OUTCOMES MEASURES: 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.

RESULTS: The mean (SD) 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=0.010). We found that 42.9% of the surgically treated glaucoma group exhibited an absence of nocturnal acrophase, while only 13.8% of the medically (difference: p=0.011). The maximum and minimum IOP-related values for the medical group were statistically higher than the surgical group (P = 0.001 and P = 0.006, respectively).

CONCLUSIONS: IOP-related fluctuations were larger in eyes with medically treated glaucoma than in surgically treated glaucoma. A significantly larger fraction of surgical group exhibited an absence of nocturnal acrophase compared to the medically treated group.