Evaluation of blood-flow parameters in extraocular arteries in patients with primary open-angle glaucoma before and after surgical treatment

Purpose
To determine blood-flow parameters in extraocular vessels in patients with primary open-angle glaucoma before and after trabeculectomy.

Material and methods
Between November and December 2002 in 18 patients (12 women and 6 men) with primary open-angle glaucoma trabeculectomy was performed. In preoperative period, 10 days after and between third and sixth month after trabeculectomy, patients were subjected to complete ocular examinaton and evaluation of blood flow velocity (mean, systolic, diastolic) and pulsation indexes in posterior ciliary arteries with Doppler's focused pulsating ultrasonography. Based on the results of the last examination patients were divided in two groups before the treatment. Group A included 9 patients (4 men and 5 women), age ranged from 46 to 77 (mean 63,67). Preoperative IOP in this group ranged from 14,6 mmHg to 34,5 mmHg (mean 25,6 mmHg). Blood-flow velocities were lowered in 9 patients for 20% below the norm. Pulsation indexes ranged from 1,0 to 1,3 in 7 patients and from 1,3 to 1,5 in 2 patients. Group B included 9 patients (6 women and 3 men) age ranged from 58 to 88 (mean 73,5). Preoperative IOP in this group ranged from 14 to 44 mmHg (mean 27,24 mmHg). Blood-flow velocities were lowered in 9 patients for 30-50% below the norm and pulsation indexes were higher then 1,2. Three of the 9 described patients had no velocities in diastolic phase and pulsation indexes were higher than 2,0.

Results
Postoperative IOP in group A ranged from 7,1 to 17,3 mmHg (mean 11,0 mmHg). Four of the 7 described patients had velocities higher for 20-30% than preoperatively and were normal. Pulsation indexes lowered to 1,0-1,2. In 3 patients velocity increase was observed later (after 6 months). In group B postoperative IOP ranged from 4,9 to 14,6 mmHg (mean 8,6 mmHg). Velocity increase was observed and it reached the lower limit of the norm or were higher. Pulsation indexes lowered to 1,0-1,2.

Conclusions
The parameters of blood-flow in posterior ciliary arteries improved in all cases after trabeculectomy.