Change of Intraocular Pressure in Trabecular Meshwork Rupture Associated with Traumatic Hyphema

Han Woong Lim; Myung Kyoo Ko

doi:10.3341/jkos.2008.49.9.1501

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Lim and Ko: Change of Intraocular Pressure in Trabecular Meshwork Rupture Associated with Traumatic Hyphema

Original Article

J Korean Ophthalmol Soc 2008;49(9):1501-1506.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.9.1501

Change of Intraocular Pressure in Trabecular Meshwork Rupture Associated with Traumatic Hyphema

Han Woong Lim, M.D., Myung Kyoo Ko, M.D.

Department of Ophthalmology, College of Medicine, Hanyang University, Seoul, Korea

Address reprint requests to Myung Kyoo Ko, M.D.Department of Ophthalmology, College of Medicine, Hanyang University Hospital #Haengdang 1-dong, Seongdong-gu, Seoul 133-792, Korea Tel: 82-2-2290-8570, Fax: 82-2-2291-8517, E-mail: fovea@hanyang.ac.kr

Received 14 May 2008 Accepted 20 November 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the relationship between the extent of rupture of the trabecular meshwork and intraocular pressure changes in traumatic hyphema patients.

Methods

Ninety-five trabecular meshwork rupture patients were selected from a group of traumatic hyphema patients. Identification and measurement of the rupture of the trabecular meshwork were performed by gonioscopy, and intraocular pressure was measured by Goldmann applanation tonometry until 3 months after the trauma.

Results

There were statistically significant differences of IOP between the traumatic eyes and the contralateral eyes at day 2, 3, 5, and 1 month ( p=0.000, 0.018, 0.001, 0.040, respectively). IOP was highest at the 2nd day post-trauma, and dropped by the 5th day, after which it rose slightly. The relationship between the extent of trabecular meshwork rupture and the difference of IOP was positive at the 2nd day post-trauma (r=0.259) and negative at the 6th day post-trauma (r=-0.296); these differences are statistically significant ( p=0.020, p=0.041, respectively).

Conclusions

A rupture of the trabecular meshwork can be measured using gonioscopy, and the change of IOP in a trabecular meshwork rupture increases as the extent of the rupture of the trabecular meshwork increases.

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Keywords: Hyphema, Intraocular pressure, Rupture of trabecular meshwork

References

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Figure 1.

Goldmann 3-mirror contact goniolens photograph. (A) Note the circumferentially full thickness trabecular meshwork rupture (arrowhead). Angle recession (deep tear into ciliary body) also present. (B) Uveal meshwork rupture combined with angle recession (arrowhead) is seen in the inferior view.

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Figure 2.

Serial change of mean IOP after blunt trauma; * p-value<0.05 by One-sample T-test.

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Table 1.

Clinical characteristics of the subjects

	Number of patients (%)
Gender
Male	83 (87.4)
Female	12 (12.6)
Age (yrs)
< 20	1 (1.1)
20~29	32 (33.7)
30~39	35 (36.8)
40~49	18 (18.9)
50~59	6 (6.3)
60~69	3 (3.2)
Laterality
Rt. Eye	51 (53.7)
Lt. Eye	44 (46.3)

Table 2.

Extent of trabecular meshwork rupture

Extent (°)	No.(%) of patients
0~90	20 (21)
120~180	33 (35)
210~360	42 (44)

Table 3.

Mean IOPs and IOP differences in patients with trabecular meshwork rupture

Time from trauma	Mean IOP (mmHg)	IOP difference (mmHg)	p-value
1 st day	14.06±2.64	-0.02	0.955
2 nd day	17.62±6.91	3.54	0.000*
3 rd day	15.87±6.42	1.79	0.018*
4 th day	14.17±5.60	0.09	0.890
5 th day	12.20±4.38	-1.88	0.001*
6 th day	13.66±4.86	-0.42	0.521
1 week	13.74±6.64	-0.34	0.764
2 weeks	13.92±6.46	-0.16	0.862
4 weeks	15.96±6.01	1.88	0.040∗
2 months	14.89±3.29	0.81	0.135
3 months	15.58±6.37	1.50	0.431

^∗ p<0.05 by one-sample t-test.

Table 4.

Correlation between trabecular meshwork rupture extents and IOP differences

Time from trauma	Correlation coefficient	p-value
1 st day	0.139	0.232
2 nd day	0.259	0.020*
3 rd day	0.031	0.789
4 th day	0.035	0.782
5 th day	-0.090	0.510
6 th day	-0.296	0.041∗
1 week	0.124	0.400
2 weeks	0.020	0.893
4 weeks	0.079	0.638
2 months	-0.286	0.368
3 months	-0.080	0.865

^∗ p<0.05 by Pearson’s correlation test.

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