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Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
Deep sclerectomy versus trabeculectomy: a morphological study with anterior segment optical coherence tomography.
Aris Konstantopoulos1, Mohammad E Yadegarfar, Ghasem Yadegarfar
1Southampton Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
The British Journal of Ophthalmology
|April 9, 2013
Summary
Deep sclerectomy (DS) lowers intraocular pressure (IOP) via trans-conjunctival aqueous percolation. A taller intrascleral lake (IL) and thicker conjunctival/Tenon
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Anatomical Imaging
Background:
- Glaucoma surgery aims to reduce intraocular pressure (IOP).
- Deep sclerectomy (DS) and trabeculectomy are common glaucoma surgical procedures.
- Anterior segment optical coherence tomography (AS-OCT) allows detailed visualization of ocular structures.
Purpose of the Study:
- To elucidate the IOP-lowering mechanisms of deep sclerectomy (DS).
- To compare AS-OCT parameters between DS, trabeculectomy, and control eyes.
- To identify AS-OCT features associated with successful glaucoma surgery outcomes.
Main Methods:
- Prospective cross-sectional study comparing AS-OCT parameters.
- Analysis included 18 DS, 17 trabeculectomy, and 15 control cases.
- Correlation of AS-OCT parameters with IOP and surgical success (IOP ≤ 16 mm Hg without medication).
Main Results:
- Successful DS cases showed a taller intrascleral lake (IL) and thicker conjunctival/Tenon's layer (CTL) compared to unsuccessful cases.
- CTL thickness correlated negatively with IOP and significantly differed across groups (controls < DS < trabeculectomy).
- Successful trabeculectomy cases exhibited a taller bleb cavity (BC).
Conclusions:
- Trans-conjunctival aqueous percolation is a newly identified drainage pathway for DS.
- The intrascleral lake (IL) in DS functions analogously to the bleb cavity (BC) in trabeculectomy.
- A substantial postoperative IL and a thick CTL are indicators of favorable surgical outcomes in DS.
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