Optic nerve head circulation after intraocular pressure reduction achieved by trabeculectomy

Ophthalmology. 2001 Mar;108(3):627-32. doi: 10.1016/s0161-6420(00)00541-8.


Objective: To study the effects of trabeculectomy and needling revision of poorly functioning blebs on the optic nerve head (ONH) circulation in patients with primary open-angle glaucoma (POAG).

Design: Prospective, nonrandomized, self-controlled trial.

Participants: Nineteen POAG patients (age range, 52 +/- 12 years; mean +/- standard deviation) undergoing trabeculectomy and six POAG patients (age range, 62 +/- 14 years) undergoing needling revision of the bleb.

Methods: Using the laser speckle method, the normalized blur (NB) value, a quantitative index of blood velocity, was determined every 0.125 seconds and averaged more than three cardiac pulses in the optic nerve head (NB(ONH)).

Main outcome measures: The NB(ONH) and intraocular pressure (IOP) in both eyes, and blood pressure (BP) and pulse rate (PR) were measured before and 2 days and 1, 4, and 8 weeks after trabeculectomy, and also before and 10 and 40 min after needling procedures.

Results: Intraocular pressure in the operated eye was significantly decreased after trabeculectomy or needling procedures, and the ocular perfusion pressure was significantly increased by a maximum of 38%. The IOP in the unoperated eye, BP, and PR did not significantly change. The NB(ONH) did not significantly change in either the operated or unoperated eye.

Conclusions: Trabeculectomy and needling procedures induced little change in the ONH circulation.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Circulation / physiology*
  • Blood Flow Velocity
  • Blood Pressure
  • Female
  • Glaucoma, Open-Angle / physiopathology*
  • Glaucoma, Open-Angle / surgery
  • Heart Rate
  • Humans
  • Intraocular Pressure*
  • Laser-Doppler Flowmetry
  • Male
  • Middle Aged
  • Optic Disk / blood supply*
  • Prospective Studies
  • Reoperation
  • Trabeculectomy*