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Influence of glaucoma surgery on the ocular surface using oculus keratograph
Sue Zhong1,2,3, Hezheng Zhou4,5, Xiao Chen2
1Southern Medical University, Guangzhou, 510515, Guangdong, China.
International Ophthalmology
|April 26, 2018
Summary
Phacotrabeculectomy temporarily impacts the ocular surface more than trabeculectomy, with tear film instability persisting long-term in both procedures. Tear meniscus height recovers, but corneal staining varies post-surgery.
Area of Science:
- Ophthalmology
- Ocular Surface Disease
- Glaucoma Surgery
Background:
- The ocular surface is crucial for visual function and comfort.
- Surgical interventions for glaucoma, such as trabeculectomy and phacotrabeculectomy, can potentially affect the ocular surface.
- Understanding these effects is vital for patient management and surgical decision-making.
Purpose of the Study:
- To compare the short-term and long-term effects of trabeculectomy and phacotrabeculectomy on key ocular surface parameters.
- To evaluate the impact of these glaucoma surgeries on tear film stability, tear meniscus height, and corneal health.
Main Methods:
- A retrospective case-control study involving 81 participants without pre-existing dry eye.
- Patients were divided into three groups: phacoemulsification (control), trabeculectomy, and phacotrabeculectomy.
- Ocular surface parameters, including noninvasive tear film breakup time (NifBUT, NiaBUT), tear meniscus height (TMH), and corneal fluorescein staining (CFS), were measured preoperatively and at 3 days, 1 month, and 3 months postoperatively.
Main Results:
- Phacotrabeculectomy showed a greater reduction in NifBUT and NiaBUT at 3 days and 1 month compared to trabeculectomy and control groups.
- While tear film parameters tended to recover, they did not return to baseline by 3 months in the trabeculectomy and phacotrabeculectomy groups.
- Tear meniscus height (TMH) increased initially but returned to baseline by 1 and 3 months across all groups. Corneal fluorescein staining (CFS) elevated post-surgery with variable recovery.
Conclusions:
- Phacotrabeculectomy exerts a more pronounced short-term negative influence on the ocular surface compared to trabeculectomy.
- Long-term differences in ocular surface impact between trabeculectomy and phacotrabeculectomy are not distinct.
- Both surgical procedures can lead to persistent tear film instability and require careful monitoring of the ocular surface.
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