ESCRS - PO975 - The Impact Of Trabeculectomy On Lamina Cribrosa And Optic Nerve Head Characteristics In Adult Versus Pediatric Patients

The Impact Of Trabeculectomy On Lamina Cribrosa And Optic Nerve Head Characteristics In Adult Versus Pediatric Patients

Published 2024 - 42nd Congress of the ESCRS

Reference: PO975 | Type: Free paper | DOI: 10.82333/z4cd-gf83

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

1Ophthalmology,Ege University,Izmir,Türkiye

Purpose

To evaluate the changes in anatomical features of optic nerve head and lamina cribrosa after trabeculectomy in adult and pediatric glaucoma patients using swept-source optical coherence tomography (SS-OCT).

Setting

The medical records and SS-OCT images of adult primary open-angle glaucoma (POAG) patients and pediatric glaucoma patients who underwent trabeculectomy at a referral center between January 2020 and January 2023 were retrospectively evaluated.

Methods

Age, gender of the patients and intraocular pressure (IOP) and retinal nerve fiber layer (RNFL) thickness of the operated eyes preoperatively and at postoperative 6th month were recorded. Changes in lamina cribrosa depth (LCD) and thickness (LCT), prelaminar tissue thickness (PLTT) and prelaminar depth (PLD) were measured in horizontal B-scan cross-sectional images of the optic nerve head obtained using SS-OCT.

Results

20 adult POAG patients (mean surgery age 62.2±9.9 years; F:6/M:14) and 19 pediatric glaucoma patients (13 aphakic/6 congenital; mean surgery age 10±3.4 years; F:7/M:12) were included. The mean LCD and PLD in adult vs. pediatric group were 583.5±77.1, 344.3±68.2 vs. 536.6±67.5, 302±51.6 µm preoperatively and 473.9±82.1, 281.3±71.5 vs. 372.6±85.8, 234.3±43.7 µm at postoperative 6th month. It was observed in both groups that after surgery, LCD and PLD decreased (p<.05) while PLTT and LCT increased (p<.05). Moreover, pediatric patients exhibited a greater reduction in LCD compared to adults (p=.03). The reduction in LCD was strongly correlated with younger age and greater IOP reduction at postoperative 6th month, both in adults and children.

Conclusions

It has been demonstrated that trabeculectomy produced a more evident reduction in LCD in the pediatric group compared to adults. This might be a result of higher elasticity of collagen and elastin fibers in lamina cribrosa at pediatric age. Further studies are needed to associate this finding with the partial/complete recovery of optic nerve cubbing observed after treatment in some pediatric glaucoma patients.