Anterior Segment Optical Coherence Topography [AS-OCT] and Corneal Topography Changes after Trabeculectomy in Patients Presenting with Primary Open Angle Glaucoma

Document Type : Original Article

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Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Primary open-angle glaucoma [POAG] is a progressive optic neuropathy characterized by elevated intraocular pressure [IOP] and damage to the optic nerve. Trabeculectomy is a common surgical intervention aimed at reducing IOP and preserving vision in patients with POAG.
The aim of the work: This study aimed to investigate the changes in anterior segment optical coherence topography [AS-OCT] and corneal topography following trabeculectomy in patients diagnosed with primary open-angle glaucoma.
Patients and Methods: A prospective study was conducted on twenty eyes of twenty patients with POAG undergoing trabeculectomy. AS-OCT and corneal topography measurements were obtained preoperatively and then three months post-operative to assess changes in the anterior segment and corneal parameters.
Results: A statistically significant increase was observed in ΔK2 [median ₌ 44.41, IQR ₌ 43.86-44.57], Δastigmatism [median ₌ 2.44, IQR ₌ 1.7-3.11], ΔACD-OCT [2.11±0.38], and ΔACA-OCT [20.8±5.01] when compared with ΔK2 [median ₌ 43.47, IQR ₌ 43.01-43.69], Δastigmatism [median ₌ 1.11, IQR ₌ 0.47-1.97], ΔACD-OCT [2.62±0.39], and ΔACA-OCT [30.9±7.8] pre-operatively. No statistically significant changes were found regarding ΔK1, Avg K, and A.
Conclusion: Astigmatism is the main reason for the diminution of visual acuity [VA] that is detected in the early weeks after operations. Decreases in anterior chamber [AC] depth and AC angle occur in the first week after trabeculectomy, reaching baseline levels before surgery after one month.

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