Changes in anterior ocular structures and macula following deep sclerectomy with collagen implant

To determine the effect of intraocular pressure (IOP) lowering with deep sclerectomy (DS) on visual acuity, macular structures, and anterior ocular dimensions during the early postoperative period.

We prospectively analyzed 35 eyes of 35 patients scheduled for DS. Our focus with the measurements was on early postoperative changes in anterior ocular and macular structures related to IOP lowering during the first month after DS. In addition to a clinical ophthalmologic examination, our measurements included corneal topography, measurement of ocular dimensions with optical biometry, and examination of macular structure with optical coherence tomography. These measurements were repeated 1, 2, and 4 weeks postoperatively.

Best-corrected visual acuity (BCVA) decreased 1 week postoperatively to 0.22 (0.20) LogMAR (p = 0.006). The BCVA then increased to its preoperative level, 0.17 (0.18) (p = 0.28), after 4 weeks. Axial length decreased from 24.12 (1.81) mm to 24.04 (1.81) (p<0.001) 4 weeks postoperatively. The steeper meridian of corneal curvature and average corneal power increased postoperatively; central corneal thickness was decreased. No significant change appeared in other measurements.

We found changes in corneal curvature and ocular dimensions after DS. These changes were relatively small and do not completely explain the decrease in visual acuity postoperatively. Macular structures showed no changes.