Trabeculectomy and optic nerve head topography

Trabeculectomy and optic nerve head topography

Author Paranhos Junior, Augusto Autor UNIFESP Google Scholar
Lima, M. C. Google Scholar
Salim, S. Google Scholar
Caprioli, J. Google Scholar
Shields, M. B. Google Scholar
Institution Yale Univ
Universidade Federal de São Paulo (UNIFESP)
Univ Calif Los Angeles
Abstract The objective of the present study was to evaluate changes in optic nerve head parameters, measured by confocal laser tomography, before and after trabeculectomy in order to identify outcome measures for the management of glaucoma. The optic nerve head of 22 eyes (22 patients) was analyzed by confocal laser tomography with the Heidelberg retinal tomogram (HRT) before and after trabeculectomy. The median time between the first HRT and surgery was 4.6 months (mean: 7.7 +/- 8.3) and the median time between surgery and the second HRT was 10.8 months (mean: 12.0 +/- 6.8). The patients were divided into two groups, i.e., those with the highest (group A) and lowest (group B) intraocular pressure (IOP) change after surgery. Differences in the 12 standard topographic parameters before and after surgery for each group were evaluated by the Wilcoxon signed rank test and the differences in these parameters between the two groups were compared by the Mann-Whitney rank sum test. Multiple regression analysis was used to evaluate the influence of the change in IOP (Delta IOP and Delta IOP%) and the changes in the other parameters. There were significant differences in the HRT measures before and after surgery in group A only for cup volume. In group B, no parameter was statistically different. The changes in group A were not significantly different than those in group B for any parameter (P > 0.004, Bonferroni correction for multiple comparisons). Delta IOP and Delta IOP% had a statistically significant effect on A cup disk area, A cup volume and A mean cup depth. Changes in cup shape size were influenced significantly only by Delta IOP. Some optic disc parameters measured by HRT presented a significant improvement after filtering surgery, depending on the amount of IOP reduction. Long-term studies are needed to determine the usefulness of these findings as outcome measures in the management of glaucoma.
Keywords optic nerve head
confocal laser tomography
intraocular pressure
Language English
Date 2006-01-01
Published in Brazilian Journal Of Medical And Biological Research. Sao Paulo: Assoc Bras Divulg Cientifica, v. 39, n. 1, p. 149-155, 2006.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Assoc Bras Divulg Cientifica
Extent 149-155
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000235089500017
SciELO ID S0100-879X2006000100017 (statistics in SciELO)

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