ESCRS - FP04.10 - Effects Of Trabeculectomy On Lamina Cribrosa And Prelaminar Tissue Characteristics

Effects Of Trabeculectomy On Lamina Cribrosa And Prelaminar Tissue Characteristics

Published 2023 - 41st Congress of the ESCRS

Reference: FP04.10 | Type: Free paper | DOI: 10.82333/tw0p-m474

Authors: Elif Akbaş Ulman* 1 , Mine Esen Baris 1 , Suzan Guven Yilmaz 1

1Ophthalmology,Ege University Faculty of Medicine,Izmir,Türkiye

Purpose

To evaluate the long-term changes in anatomical features of lamina cribrosa and prelaminar tissue after trabeculectomy using spectral-domain optical coherence tomography (SD-OCT).

Setting

The medical records and SD-OCT images of primary open-angle glaucoma patients who underwent trabeculectomy at a referral center between January 2020 and January 2022 were evaluated retrospectively.

Methods

Age, gender of the patients and intraocular pressure (IOP) and RNFL thickness of the operated eyes at post-operative 6th month and the last visit which was performed at least 1 year postoperatively (LV) were recorded. Changes in lamina cribrosa depth (LCD) and thickness (LCT), prelaminar tissue thickness (PLTT) and prelaminar depth (PLD) were measured on horizontal B-scan cross-section images of the optic nerve head obtained using SD-OCT, preoperatively, at postoperative 6 months, and at the last visit (LV).

Results

A total 24 patients (F:5/M:19) with median age of 62 (47-76) years were included in the study. Mean IOP decreased from 35.8 ± 8.76 mmHg to 13.67±3.16 mmHg at 6 months postoperatively and to 15.21±3.52 mmHg at the LV (mean 20.6±16.7 months). While the mean LCD was 592.79±207.02 µm preoperatively, it decreased to 477.62±162.76 µm at postoperative 6th month and to 491.67±173.09 µm with a moderate increase at LV. The reduction in LCD was associated with lower postoperative IOP (r=-0.44), higher IOP reduction (r=0.55) and younger age (r=-0.62), at postoperative 6 months. At LV, LCD reduction was only found to be associated with higher baseline RNFL thickness (r=0.46). LCT, PLTT and PLD did not show a significant relationship with any variable.

Conclusions

The postoperative reduction in LCD observed at postoperative 6th month was higher in patients with higher IOP reductions. The decrease in LCD was maintained in patients with good initial RNFL thickness, in the long-term.