Abstract
Computerized anterior-chamber fluorophotometry was used to investigate the effect of unilateral antiglaucomatous trabeculectomy on the dynamics of aqueous humor in the unoperated fellow eye. In 14 patients with bilateral primary open-angle glaucoma, pigmentary glaucoma or exfoliation glaucoma, antiglaucomatous trabeculectomy was performed in one eye in which medical management of glaucoma had failed. The fellow eye in all patients had a well-defined history of glaucoma and had been treated with different sorts of medication. The medical management of the unoperated fellow eyes was continued throughout the study. Aqueous humor flow was measured in these eyes prior to surgery and on the 5th day after trabeculectomy. Systemic medication was discontinued from 48 h prior to surgery until second fluorophotometry. The average postoperative flow in the fellow eyes increased from 2.56 to 2.92 μl/min (P<0.05%, paired t-test). The increase in flow in the fellow eyes was independent of topical antiglaucoma medication and of the diurnal rhythm of aqueous humor dynamics. The results of the study indicate that filtration surgery in one eye triggers a CNS-mediated, reflective increase in aqueous flow to maintain physiological stability in the anterior chamber of the surgically treated eye. Since this CNS reflex on aqueous humor dynamics affects both eyes, the clinical observation of intraocular pressure (10P) dysregulation in the unoperated fellow eye following unilateral trabeculectomy is now understandable.
Similar content being viewed by others
References
Araie M, Takase M (1981) Effect of various drugs on aqueous humor dynamics in man. Jpn J Ophthalmol 25:91–93
Beitch Br, Eakias KE (1969) The effect of prostaglandins on the intraocular pressure of the rabbit. Br J Pharmacol 37:158–161
Gibbens MV (1988) The consensual ophthalmotonic reaction. Br J Ophthalmol 72:746–749
Gibbens MV (1988) Sympathetic influences on the consensual ophthalmotonic reaction. Br J Ophthalmol 72:750–753
Grant WM, English FP (1963) An explanation for so-called consensual pressure drog during tonography. Arch Ophthalmol 69:314–316
Gwin RM, Gelatt KW, Gum GG, Pfeiffer RL (1978) Effects of topical 1-epinephrine and dipivalyl epinephrine on intraocular pressure and pupil size in the normotensive and glaucomatous beagle. Am J Vet Res 39:83–86
Hofe K von (1930) Hypertonie und kompensatorische Hypotonie am Auge. Arch Augenheilkd 102:315–317
Jay JL, Murray SB (1980) Characteristics of reduction of intraocular pressure after trabeculectomy. Br J Ophthalmol 64:432–435
Krieglstein GK (1985) Zur Prognose der Filtrationschirurgie bei Glaukomspätstadien. Prakt Augenheilkd 6:121–129
Langham ME, Diggs EM (1974) β-Adrenergic response in the eyes of rabbits, primates and man. Exp Eye Res 19:281–287
Larson S (1931) Weitere Beiträge zur Kenntnis über posttraumatische, als konsensuelle intraokulare Drucksenkung beobachtete Reizübertragung. Acta Ophthalmol 9:85–89
Lepper RD, Trier HG (1984) The accuracy of ultrasonic biometry of the eye in dependence on the examiner's skill. Proceeding of th 10th Meeting of the St. Petersburg, Florida, pp 23–25
Linnen HJ (1950) Über Beobachtungen konsensueller ophthalmologischer Reaktionen bei Experimenten an Kaninchenaugen. Klin Monatsbl Augenheilkd 102:315
Linner E (1989) Kammerwasserabflußwege nach Trabekulektomie bei Glaukompatienten. Klin Monatsbl Augenheilkd 195:291–293
Lütjen-Drecoll E (1982) Functional morphology of the ciliary epithelium. In: Lütjen-Drecol E (ed) Basic aspects of glaucoma research. Schattauer, Stuttgart, pp 68–89
Nagitot A (1933) Reactions croisees oculo-oculaires. Ann Ocul 170:465–467
Nagataki S (1975) Aqueous humor dynamics of human eyes as studied using fluorescein. Jpn J Ophthalmol 19:235–242
Perkins ES (1957) Influence of the fifth cranial nerve on the intraocular pressure of the rabbit eye. Br J Ophthalmol 41: 257–261
Prijot EL, Stone HH (1956) On the ophthalmotonic consensual reaction and its relationship to aqueous humor dynamics. Am J Ophthalmol 42:50–55
Radius RL, Diamond GR, Pollack IP, Langham ME (1978) Timolol. A new drug for management of chronic simple glaucoma. Arch Ophthalmol 96:1003–1007
Ramxlaar JAM, Boot JP, Van Haeringen NJ, Van Best JA, Oosterhuis JA (1988) Corneal epithelial permeability after instillation of ophthalmic solutions containing local anaesthetics and preservatives. Curr Eye Res 7:947–952
Schwartz AL, Whitten ME, Bleiman B, Martin D (1981) Argon laser trabecular surgery in uncontrolled phakic open-angle glaucoma. Ophthalmology 88:203–209
Shields MB (1982) A study guide for glaucoma. Williams & Wilkins, Baltimore London, pp 412–416
Simmons RJ (1986) Filtering operations. In: Chandler PA, Grant WM (eds) Glaucoma, 3rd edn. Lea & Febiger, Philadelphia, pp 428–429
Stocker FW (1958) On changes in intraocular pressure after application of the tonometer. Am J Ophthalmol 45:192–196
Weekers L (1924) Modifications expérimentales de l'ophthalmotonus. Reaction ophthalmotonique consensuelle. Arch Ophthalmol 41:641–644
Wilmer WE (1927) Discussion on the results of operative treatment of glaucoma. Trans Ophthalmol Soc UK 47:230–233
Yablonski ME, Zimmerman TJ, Waltman SR, Becker B (1978) A fluorophotometric study of the effect of topical timolol on aqueous humor dynamics. Exp Eye Res 27:135–139
Zypen E van der, Frankhauser F, Kwasniewska S (1989) The mechanism of aqueous outflow following trabeculectomy. Intern Ophthalmol 13:219–228
Author information
Authors and Affiliations
Additional information
Offprint requests to: M. Diestelhorst
Rights and permissions
About this article
Cite this article
Diestelhorst, M., Krieglstein, G. The effect of trabeculectomy on the aqueous humor flow of the unoperated fellow eye. Graefe's Arch Clin Exp Ophthalmol 229, 274–276 (1991). https://doi.org/10.1007/BF00167883
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00167883