Comparison of Mean Retinal Nerve Fiber Layer Thickness on Optical Coherence Tomography (OCT) in Patients of Primary Open Angle Glaucoma (POAG) After Trabeculectomy vs Anti Glaucoma Medication
Retinal Nerve Fiber Layer Thickness
DOI:
https://doi.org/10.54393/pjhs.v4i05.699Keywords:
Primary Open Angle Glaucoma, Optical Coherence Tomography (OCT), Retinal Nerve Fibre Layer Thickness, TrabeculectomyAbstract
Trabeculotomy is a surgical procedure in which a fistula is created between anterior chamber and sub-conjunctival space for drainage of aqueous. Glaucoma is a chronic disease. Objective: To compare the mean retinal nerve fibre layer thickness in patients of primary open angle glaucoma after trabeculectomy versus anti glaucoma medication. Methods: This Randomized controlled study done in Institute of Ophthalmology, Eye Unit III, KEMU, Mayo Hospital, Lahore from 10th Nov 2021 to 10th May 2022. Non-Probability Convenient Sampling technique used for sample size calculation. 60 patients were selected fulfilling the inclusion and exclusion criteria. They were divided into two groups of 30 patients each. Group A patient were given topical anti-glaucoma treatment while Group B patients underwent trabeculectomy. Pre and three months post anti-glaucoma medication/trabeculectomy, OCT test was done and thickness of retinal nerve fibre layer documented. Results: In group A, mean post-treatment RNFL thickness was 0.076 ± 0.052 microns after three months of topical treatment. In group B, mean post-treatment RNFL thickness was 0.080 ± 0.0048 microns three months after trabeculectomy. Conclusions: Trabeculectomy increases the mean retinal nerve fibre layer thickness more than anti-glaucoma medication when measured on OCT.
References
Geyer O, Ben-Shaul O, Lux C, Schwartz S, Podkovyrin O, Stein N, et al. Effect of Femtosecond Laser Cataract Surgery on Peripapillary Retinal Nerve Fiber Layer Thickness. Journal of Glaucoma. 2022 May; 31(5): 340-5. doi: 10.1097/IJG.0000000000002014. DOI: https://doi.org/10.1097/IJG.0000000000002014
Thomas R, Walland M, Thomas A, Mengersen K. Lowering of intraocular pressure after phacoemulsification in primary open-angle and angle-closure glaucoma: a bayesian analysis. The Asia-Pacific Journal of Ophthalmology. 2016 Jan; 5(1): 79-84. doi: 10.1097/APO.0000000000000174. DOI: https://doi.org/10.1097/APO.0000000000000174
Ramezani F, Nazarian M, Rezaei L. Intraocular pressure changes after phacoemulsification in pseudoexfoliation versus healthy eyes. BMC Ophthalmology. 2021 May; 21(1): 198. doi: 10.1186/s12886-021-01970-y. DOI: https://doi.org/10.1186/s12886-021-01970-y
Khan MI, Arif SA, MT HK, Khan MA, Saleem M. To assess the role of cataract extraction in glaucoma management by its intraocular pressure lowering effect. JPMA. The Journal of the Pakistan Medical Association. 2021 Apr; 71(4): 1100-2.
Zheng Q, Hu M, Li ZL, Chang PJ, Zhao YE. Assessment of anterior chamber angle changes after phacoemulsification with swept-source OCT. International Journal of Ophthalmology. 2021 Oct; 14(10): 1527.
Koenig SF and Hirneiss CW. Changes of neuroretinal rim and retinal nerve fiber layer thickness assessed by optical coherence tomography after filtration surgery in glaucomatous eyes. Clinical Ophthalmology. 2021 Jun; 15: 2335-44. doi: 10.2147/OPTH.S298045. DOI: https://doi.org/10.2147/OPTH.S298045
Zuo C, Long B, Guo X, Chen L, Liu X. Effect of phacoemulsification on anterior chamber angle in eyes with medically uncontrolled filtered primary angle-closure glaucoma. Journal of Ophthalmology. 2020 Apr; 2020: 8720450. doi: 10.1155/2020/8720450. DOI: https://doi.org/10.1155/2020/8720450
Rafique A, Khan AA, Shaheer M. Changes in retinal nerve fiber layer thickness on heidelberg retinal tomography in patients of primary open angle glaucoma after trabeculectomy versus anti glaucoma medication. Khyber Medical University Journal. 2020 Sep; 12(3): 211-5.
Abdelghany AA, Sallam MA, Ellabban AA. Assessment of ganglion cell complex and peripapillary retinal nerve fiber layer changes following cataract surgery in patients with pseudoexfoliation glaucoma. Journal of Ophthalmology. 2019 Sep; 2019: 8162825. doi: 10.1155/2019/8162825. DOI: https://doi.org/10.1155/2019/8162825
Pandav SS, Seth NG, Arora A, Thattaruthody F, Jurangal A, Kaushik S, Raj S. Intraocular pressure reduction in a spectrum of angle closure disease following cataract extraction. Indian Journal of Ophthalmology. 2019 Sep; 67(9): 1433. doi: 10.4103/ijo.IJO_1917_18. DOI: https://doi.org/10.4103/ijo.IJO_1917_18
Majstruk L, Leray B, Bouillot A, Michée S, Sultan G, Baudouin C, et al. Long-term effect of phacoemulsification on intraocular pressure in patients with medically controlled primary open-angle glaucoma. BMC Ophthalmology. 2019 Dec; 19: 1-7. doi: 10.1186/s12886-019-1157-3. DOI: https://doi.org/10.1186/s12886-019-1157-3
Amjad A, Shaheer M, Rafique A. Retinal Nerve Fiber Layer Thickness Changes after Phacoemulsification with Intraocular Lens Implantation. Journal of College of Physicians and Surgeons Pakistan. 2018 Dec; 28(12): 919-22. doi: 10.29271/jcpsp.2018.12.919. DOI: https://doi.org/10.29271/jcpsp.2018.12.919
Nasar MK, Zaky MA, Saleh HA. Evaluation of peripapillary retinal nerve fiber thickness and macular changes before and after phacoemulsification. Menoufia Medical Journal. 2018 Oct; 31(4): 1342.
Yang HS, Lee J, Choi S. Ocular biometric parameters associated with intraocular pressure reduction after cataract surgery in normal eyes. American Journal of Ophthalmology. 2013 Jul; 156(1): 89-94. doi: 10.1016/j.ajo.2013.02.003. DOI: https://doi.org/10.1016/j.ajo.2013.02.003
Lv H, Yang J, Liu Y, Jiang X, Liu Y, Zhang M, et al. Changes of intraocular pressure after cataract surgery in myopic and emmetropic patients. Medicine. 2018 Sep;97(38): e12023. doi: 10.1097/MD.0000000000012023. DOI: https://doi.org/10.1097/MD.0000000000012023
Yoo C, Amoozgar B, Yang KS, Park JH, Lin SC. Glaucoma severity and intraocular pressure reduction after cataract surgery in eyes with medically controlled glaucoma. Medicine. 2018 Oct; 97(42): e12881. doi: 10.1097/MD.0000000000012881. DOI: https://doi.org/10.1097/MD.0000000000012881
Lin SC, Masis M, Porco TC, Pasquale LR. Predictors of intraocular pressure after phacoemulsification in primary open-angle glaucoma eyes with wide versus narrower angles (an American ophthalmological society thesis). Transactions of the American Ophthalmological Society. 2017 Aug; 115: T6.
Perez CI, Chansangpetch S, Feinstein M, Mora M, Nguyen A, Badr M, et al. Novel gonioscopy score and predictive factors for intraocular pressure lowering after phacoemulsification. Journal of Glaucoma. 2018 Jul; 27(7): 622-6. doi: 10.1097/IJG.0000000000000976. DOI: https://doi.org/10.1097/IJG.0000000000000976
Lee W, Bae HW, Kim CY, Seong GJ. The change of anterior segment parameters after cataract surgery in normal-tension glaucoma. International Journal of Ophthalmology. 2017 Aug; 10(8): 1239-45.
Agarwal A and Jacob S. Current and effective advantages of femto phacoemulsification. Current Opinion in Ophthalmology. 2017 Jan; 28(1): 49-57. doi: 10.1097/ICU.0000000000000333. DOI: https://doi.org/10.1097/ICU.0000000000000333
Jha B, Sharma R, Vanathi M, Agarwal T, Sidhu T, Tomar A, et al. Effect of phacoemulsification on measurement of retinal nerve fiber layer and optic nerve head parameters using spectral-domain-optical coherence tomography. Oman Journal of Ophthalmology. 2017 May; 10(2): 91.
F Mohammed M. Changes of peripapillary nerve fiber layer and foveal thickness measurements by optical coherence tomography after phacoemulsification in non-diabetic non-glaucomatous patients with senile grade 1+ cataract. Al-Azhar Medical Journal. 2017 Oct; 46(4): 939-52. doi: 10.12816/0045177. DOI: https://doi.org/10.12816/0045177
Perdana OP, Victor AA, Oktarina VD, Prihartono J. Changes in peripapillary retinal nerve fiber layer thickness in chronic glaucoma and non-glaucoma patients after phacoemulsification cataract surgery. Medical Journal of Indonesia. 2015 Dec; 24(4): 221-7. doi: 10.13181/mji.v24i4.1181. DOI: https://doi.org/10.13181/mji.v24i4.1181
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