Short-term changes in Bruch's membrane opening-based morphometrics during the first week after trabeculectomy.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Optical Coherence Tomography

Background:

• Glaucoma surgery aims to reduce intraocular pressure (IOP) to prevent optic nerve head (ONH) damage.
• Trabeculectomy with mitomycin C is a common surgical procedure for glaucoma.
• Assessing early structural changes in the ONH after surgery is crucial for understanding treatment efficacy.

Purpose of the Study:

• To investigate the early dynamic changes in Bruch's membrane opening (BMO)-based morphometrics of the ONH after trabeculectomy with mitomycin C.
• To evaluate the relationship between these structural changes and intraocular pressure (IOP) reduction in the first postoperative week.

Main Methods:

• Prospective, longitudinal study of 25 eyes undergoing trabeculectomy with mitomycin C.
• Spectral-domain optical coherence tomography (SD-OCT) was used to measure BMO minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness.
• Measurements were taken at baseline, and at 1 day, 2-3 days, and 1 week post-surgery, correlated with IOP.

Main Results:

• A significant increase in BMO-MRW was observed as early as 1 day post-surgery (+26.17 µm), correlating with IOP reduction.
• This BMO-MRW increase persisted through day 2-3 (+25.33 µm) and week 1 (+33.17 µm).
• RNFL thickness showed no significant change at days 1-3 but increased slightly by week 1 (+3.94 µm).

Conclusions:

• Trabeculectomy with mitomycin C leads to rapid structural reversal of disc cupping (BMO-MRW) within the first postoperative day.
• The early structural changes are strongly correlated with the degree of IOP reduction.
• BMO-based parameters are important for evaluating longitudinal follow-up in glaucoma patients post-surgery.