Mahmood Ali, Farah Akhtar.
Ocular digital massage for the management of post- trabeculectomy underfiltering blebs.
J Coll Physicians Surg Pak Jan ;21(11):676-9.

Objective: To evaluate the efficacy and safety of ocular digital massage (ODM) in the management of underfiltering blebs after trabeculectomy. Study Design: Quasi experimental study. Place and Duration of Study: Glaucoma Clinic of Al-Shifa Trust Eye Hospital, Rawalpindi, from January 2007 to November 2008. Methodology: ODM was performed 3-4 times daily in 20 eyes having intraocular pressure (IOP) above the target level after trabeculectomy. Equal number of eyes with satisfactory IOP after trabeculectomy were taken as controls. Both groups were evaluated at 1 week, 3 weeks, 6 weeks, 3 months, 6 months and 9 months. Mean IOP, frequency of complications and required number of IOP lowering medicines in both groups were compared using 't' test. Results: Massage group had a significantly higher mean IOP than the control group before the initiation of massage (p < 0.001). After initiating ODM, there were no significant differences in the mean IOP of two groups at 1 week (p = 0.421), 3 weeks (p = 0.073), 6 weeks (p = 0.575), 3 months (p = 0.071), 6 months (p = 0.085) and 9 months (p = 0.369). The difference in terms of required number of IOP lowering medicines (p = 0.075) and complication rates (p = 0.411) was also not significant. Conclusion: ODM is an effective method for controlling IOP after trabeculectomy, and thus contributes to long-term surgical success with an acceptable risk / benefit ratio.

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