Postural Intraocular Pressure Change at Trendelenberg Position Measured by Rebound Tonometer

Sa Kang Kim; Jae Young Ko; Jun Bo Sim; Ki Ho Park

doi:10.3341/jkos.2014.55.2.247

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Kim, Ko, Sim, and Park: Postural Intraocular Pressure Change at Trendelenberg Position Measured by Rebound Tonometer

Original Article

J Korean Ophthalmol Soc 2014;55(2):247-251.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.2.247

Postural Intraocular Pressure Change at Trendelenberg Position Measured by Rebound Tonometer

Sa Kang Kim, MD¹, Jae Young Ko², Jun Bo Sim², Ki Ho Park, MD, PhD¹

¹Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

²Department of Medicine, Seoul National University College of Medicine, Seoul, Korea

Address reprint requests to Ki Ho Park, MD, PhD Department of Ophthalmology, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea, Tel: 82-2-2072-2438, Fax: 82-2-741-3187, E-mail: kihopark@snu.ac.kr

Received 26 April 201327 November 2013 Accepted 8 January 2014

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

This study was carried out to evaluate the postural intraocular pressure (IOP) change in Trendelenburg, reverse Trendelenburg, and supine positions in healthy young males.

Methods

We measured the IOP values of 5 healthy young male volunteers (10 eyes) using an Icare PRO rebound tonometer in sitting, Trendelenburg, reverse Trendelenburg, and supine positions.

Results

The mean IOP in the supine position (18.63 mm Hg) was significantly higher (p < 0.01) than in the sitting position (15.31 mm Hg). When maintaining the Trendelenburg position, IOP gradually increased.

Conclusions

In our study, the Trendelenburg position significantly increased the IOP compared to that in the supine position. The effects of increased IOP should be considered in situations that require Trendelenburg positioning, such as exercise or surgery.

Keywords: Icare Pro, Intraocular pressure, Reverse Trendelenburg position, Supine position, Trendelenburg position

References

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Figure 1.

Illustration of experimental positions. Reverse Trend- enlenburg position (T3, 4, 5, 6) (A) and Trendelenburg pos-iton (T8, 9, 10) (B). Red arrow indicates the direction of patient's eyes.

Figure 2.

Icare PRO rebound tonometer (Icare® PRO; Icare Finland Oy, Helsinki, Finland) Front view (A) and rear view (B) of Icare PRO, (C) display during measuring IOP, (D) display after measuring IOP, showing reliability below IOP. IOP = intraocular pressure.

Figure 3.

Scatter plot of the IOP with the overlaid line con-necting the mean IOP at each time point. IOP = intraocular pressure; T1 = Sitting; T2 = 10 minutes after supine position; T3 = 10 minutes after reverse Trendelenburg position; T4 = 20 minutes after reverse Trendelenburg position; T5 = 30 minutes after reverse Trendelenburg position; T6 = 60 minutes after reverse Trendelenburg position; T7 = 10 minutes after supine position; T8 = 10 minutes after Trendelenburg position; T9 = 20 minutes after Trendelenburg position; T10 = 30 minutes after Trendelenburg position. ^* Indicates significant difference compared to T1 (p < 0.05, Tahame’s test). ^† Indicates significant difference compared to T2 (p < 0.05, Tahame’s test). ^‡Indicates significant difference between T8 and T10 (p < 0.05, Tahame’s test).

Table 1.

T1-T10 Time points of measurement and mean intraocular pressure of each time point

Time point	Position	Intraocular pressure (mm Hg)
T1	Sitting	15.31 ± 0.86
T2	10 minutes after supine position	18.63 ± 1.34
T3	10 minutes after reverse Trendelenburg position	17.81 ± 1.06
T4	20 minutes after reverse Trendelenburg position	17.34 ± 1.03
T5	30 minutes after reverse Trendelenburg position	16.84 ± 0.69
T6	60 minutes after reverse Trendelenburg position	16.43 ± 0.32
T7	10 minutes after supine position	18.15 ± 1.14
T8	10 minutes after Trendelenburg position	23.03 ± 1.21
T9	20 minutes after Trendelenburg position	25.42 ± 1.95
T10	30 minutes after Trendelenburg position	26.36 ± 1.83

Values are presented as mean ± SD.

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