AIM:To study the effect of postural change on intraocular pressure(IOP)fluctuation in open angle glaucoma patients after trabeculectomy, and to discuss the value of this investigation on prognosis.

METHODS: Fifty-one cases(62 eyes)of primary open angle glaucoma were selected as the research object. Perkins ophthalmotonometer was used to test IOP at the time when patient seat(first seat). The patients were asked to lie supine for 25min, detected IOP, and the patients seated again(final seat), sustaining for 15min, detected IOP. According to whether the IOP range was more than 5mmHg, they were divided into high volatility fluctuation group and low volatility fluctuation group. We recorded their visual field progression(with AGIS score), HPA staging, in order to evaluate the correlation of IOP range with them. Reviews were made 3mo a time, and lasted for 1a, in order to evaluate the relation between IOP range and AGIS scores.

RESULTS: The IOP of first seat was 18.1+2.2mmHg. There was no significant difference in the same position(P>0.05). The IOP range was 4.1±1.5mmHg. Low volatility fluctuation group was more likely to have low AGIS score and to be early vision HPA(P<0.001, P<0.05). There were significantly positive correlation between IOP range and AGIS(r=0.412, P<0.001); With time increasing, the number of patients whose visual field progression was increased, and the IOP was also raised. At any time the two were positively correlated(P<0.01).

CONCLUSION: Visual field progression is related to the degree of IOP fluctuation in open angle glaucoma patients after trabeculectomy, so we can predict the prognosis of patients simply by detect IOP fluctuation. This is good to adjust the IOP control scheme.