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Graefe's Archive for Clinical and Experimental Ophthalmology

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Open Access 01-04-2018 | Glaucoma

Evaluating displacement of lamina cribrosa following glaucoma surgery

Authors: Patrycja Krzyżanowska-Berkowska, Aleksandra Melińska, Iwona Helemejko, D. Robert Iskander

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 4/2018

Abstract

Purpose

The purpose of the study is to assess the displacement of lamina cribrosa (LC) and prelaminar tissue area (PTA) changes following trabeculectomy and non-penetrating deep sclerectomy (NPDS) using spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging technology.

Methods

A total of 30 patients underwent glaucoma surgery. Sixteen patients underwent trabeculectomy, and 14 patients undertook NPDS. Serial horizontal B-scan images of optic nerve head (ONH) were obtained using SD-OCT preoperatively, and at 2-week, 1-, 3-, and 6-month postoperative visit (6 pv). LC displacement magnitude and PTA changes were determined from selected B-scan images. Correspondingly, OCT retinal nerve fiber layer (RNFL) parameters were measured.

Results

Intraocular pressure (IOP) decreased from 27.4 ± 10.3 mmHg (mean ± standard deviation) to 10.2 ± 4.0 mmHg (P = 0.011) and from 19.9 ± 4.0 mmHg to 11.9 ± 3.6 mmHg (P = 0.012) at 6 pv, for trabeculectomy and NPDS, respectively. There was a significant decrease in the LC depth from a baseline glaucomatous LC displacement of 468.0 ± 142.4 to 397.6 ± 125.2 μm in the trabeculectomy group (P = 0.001) and from 465.2 ± 129.6 to 412.0 ± 122.4 μm in the NPDS group (P = 0.029) at 6 pv. The PTA differed between the procedures at baseline (P = 0.002), but was not statistically significant postoperatively. Multivariate analysis for all patients including age, magnitude of IOP reduction, baseline glaucomatous LC displacement, magnitude of LC displacement, and the type of surgery revealed that only the magnitude of LC displacement was associated with significant RNFL thinning on average (r² = 0.162, P = 0.027) and in the following sectors: temporal superior (r² = 0.197, P = 0.014), temporal (r² = 0.150, P = 0.034), and nasal superior (r² = 0.162, P = 0.027).

Conclusions

Decrease in the LC depth after NPDS surgery can be observed at 6 pv. Regardless of the performed procedure, magnitude of LC displacement is associated with significant, focal RNFL thinning.

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Title: Evaluating displacement of lamina cribrosa following glaucoma surgery
Authors: Patrycja Krzyżanowska-Berkowska
Aleksandra Melińska
Iwona Helemejko
D. Robert Iskander
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 4/2018
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-018-3920-1

At a glance: The STEP trials

Springer Medicine

Evaluating displacement of lamina cribrosa following glaucoma surgery

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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