方法：选择51例62眼原发性开角型青光眼患者为研究对象。以Perkins压平眼压计检测患者坐位(初坐位)眼压后，要求患者平卧25min，检测眼压，继而要求患者行坐位(终坐位)，持续15min，检测眼压。按眼压极差是否≥5mmHg将其划分为高波动组和低波动组。统计视野进展情况(以AGIS得分评价)、HPA分期，评价眼压极差与其相关性。每3mo复查，持续1a，评价眼压极差与AGIS得分变化趋势。

结果：初坐位眼压18.1±2.2mmHg，同一体位多时点眼压无显著差异(P>0.05)，眼压极差4.1±1.5mmHg； 低波动组AGIS视野稳定者及HPA早期者显著多于高波动组(P<0.001； P<0.05)，眼压极差与AGIS显著正相关(r=0.412，P<0.001)； 随时间延长，视野进展人数上升，眼压极差上升，且任意时刻两者间均呈显著正相关(P<0.01)。

结论：小梁切除术后患者体位改变下眼压波动与视野进展程度有关，可通过检测眼压波动简单预测患者预后，从而调整眼压控制方案。

METHODS: Fifty-one cases(62 eyes)of primary open angle glaucoma were selected as the research object. Perkins ophthalmotonometer was used to test IOP at the time when patient seat(first seat). The patients were asked to lie supine for 25min, detected IOP, and the patients seated again(final seat), sustaining for 15min, detected IOP. According to whether the IOP range was more than 5mmHg, they were divided into high volatility fluctuation group and low volatility fluctuation group. We recorded their visual field progression(with AGIS score), HPA staging, in order to evaluate the correlation of IOP range with them. Reviews were made 3mo a time, and lasted for 1a, in order to evaluate the relation between IOP range and AGIS scores.

RESULTS: The IOP of first seat was 18.1+2.2mmHg. There was no significant difference in the same position(P>0.05). The IOP range was 4.1±1.5mmHg. Low volatility fluctuation group was more likely to have low AGIS score and to be early vision HPA(P<0.001, P<0.05). There were significantly positive correlation between IOP range and AGIS(r=0.412, P<0.001); With time increasing, the number of patients whose visual field progression was increased, and the IOP was also raised. At any time the two were positively correlated(P<0.01).

CONCLUSION: Visual field progression is related to the degree of IOP fluctuation in open angle glaucoma patients after trabeculectomy, so we can predict the prognosis of patients simply by detect IOP fluctuation. This is good to adjust the IOP control scheme.