Abstract: Objective To observe the intraocular pressure(IOP)fluctuations and the phenomenon of ophthalmotonic consensual reaction(OCR)in the fellow eye following trabectome in one eye and to investigate its correlative influencing factors in patients with open-angle glaucoma(OAG). Methods In this single-center retrospective observational study, the eyes of 97 individuals with OAG undergoing unilateral trabectome from January 2016 to September 2022 were evaluated. Data were collected on demographics, past ocular disease and surgical history, the kind and number of preoperative anti-glaucoma medications, ophthalmic examination data, including baseline IOP in both eyes, and the IOP of both eyes at one day, one week, one month, three months, and six months postoperatively. An IOP change(ΔIOP)≥ 4 mm Hg or a 20% increase from the baseline values was defined as OCR in the fellow eye. Paired rank sum test was used to compare the difference between baseline IOP values and IOP at different time points postoperatively, and the influencing factors of OCR phenomenon in the fellow eye on postoperative day 1 were investigated using rank sum test, Fisher’s exact test, and logistic regression, while the influencing factors of the magnitude of ΔIOP in the fellow eye at postoperative day 1 were investigated using rank sum test and Spearman correlation analysis. Results The baseline IOP of all fellow eyes was 17.3±6.5 mm Hg, significantly increasing to 18.1±7.8 mm Hg at postoperative day 1(P=0.008), while IOP in the fellow at other postoperative time points did not significantly change from the baseline level(P>0.05). The incidence of OCR in fellow eyes at postoperative day 1 was 34.0%, which was higher than those of other postoperative time points. Healthy fellow eye was an independent risk factor of OCR in the fellow eye following trabectome in the surgical eye at postoperative day 1. At postoperative day 1, ΔIOP in fellow eyes was positively correlated with the magnitude of IOP reduction and the baseline IOP level in surgical eyes. Conclusion A consensual IOP rise in fellow eyes was observed after trabectome in one eye in the early postoperative period. These findings highlight the explicit need to monitor IOP in fellow eyes carefully.

Key words: Fellow eye, Open-angle glaucoma, Ophthalmotonic consensual reaction, Trabectome, Fluctuations of IOP