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¹Osman Gazi Üniv. Tıp Fakl. Göz Hast. A.D., Eskişehir
²Ankara
³Selçuk Üniv. Tıp Fakl. Göz Hast. A.D., Konya
⁴Hacettepe Üniv. Tıp Fakl. Göz Hast. A.D., Ankara
⁵Hacettepe Üniv. Tıp Fakl. Biyoistatistik A.D., Ankara Purpose: Assessment of optic nerve head (ONH) and retinal nerve fiber layer (RNFL) changes following trabeculectomy with scanning laser ophthalmoscopy and scanning laser polarimetry in glaucoma patients.
Materials and Methods: 16 eyes of 13 patients who had underwent trabeculectomy were evaluated with ONH topography (Topographic Scanning System, TopSS) and RNFL polarimetric analysis (NFA, GDx) preoperatively, and at 1 month, 3 months and 6 months postoperatively. TopSS and GDx parameters measured before and after trabeculectomy were compared using paired sample t-test and p<0.05 was considered to be statistically significant..
Results: After trabeculectomy, IOP reduced from 32.56±8.51 mmHg to 14.68±3.04 mmHg at 1 month, 13.82±3.04 mmHg at 3 months and 15.78±1.04 mmHg at 6 months. The mean neuroretinal rim area (NRRA) was found to be increased at 1 month (1.430 mm²±1.12), 3 months (1.540 mm²±1.15), 6 months (1.429 mm²±1.12) after trabeculectomy when compared with the initial measurement (1.367 mm²±1.16) (p<0.05). C/D ratio, half depth volume (1/2 DV) and half depth area (1/2 DA) decreased by months 1, 3 and 6 when compared with the preoperative measurements. None of the GDx parameters showed statistically significant changes following trabeculectomy(p>0,05).
Discussion: Although NRRA and cup parameters were found to be significantly changed on topography, all of the GDx parameters including the average thickness, remained stable following trabeculectomy which could be explained by the removal of the mechanical effect of IOP on the ONH and the anterior movement of lamina cribrosa after a IOP decrease. Keywords : Trabeculectomy, optic nerve head topography, retinal nerve fiber layer, glaucoma