Early Macular Thickness Changes after Trabeculectomy and Combined Phaco-Trabeculectomy

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Retinal Imaging

Background:

• Glaucoma management often requires surgical intervention.
• Trabeculectomy and combined phaco-trabeculectomy are common glaucoma surgeries.
• Assessing postoperative retinal changes is crucial for patient outcomes.

Purpose of the Study:

• To evaluate changes in central retinal thickness (RT) after trabeculectomy versus combined phaco-trabeculectomy.
• To compare the impact of these two surgical techniques on retinal thickness using spectral domain-optical coherence tomography (SD-OCT).

Main Methods:

• A prospective comparative study included 64 glaucoma patients undergoing either trabeculectomy (32 eyes) or phaco-trabeculectomy (32 eyes).
• Retinal thickness was measured using SD-OCT at 9 subfields (central, parafoveal, perifoveal) preoperatively and at 1 and 3 months post-surgery.
• Macular thickness maps based on Early Treatment Diabetic Retinopathy Study (ETDRS) circles were utilized for analysis.

Main Results:

• The combined phaco-trabeculectomy group showed a significant increase in RT at 1 month in several parafoveal and perifoveal subfields, which mostly resolved by 3 months, except in the temporal perifoveal region.
• The trabeculectomy-only group exhibited no statistically significant RT changes at 1 or 3 months post-surgery.
• No significant differences in central subfield retinal thickness (CSRT) or parafoveal RT changes were observed between the two groups over time.

Conclusions:

• Both trabeculectomy and combined phaco-trabeculectomy demonstrated comparable changes in central retinal thickness (CSRT) and parafoveal RT up to 3 months post-surgery.
• Temporary increases in RT following combined phaco-trabeculectomy generally resolve, with the exception of the temporal perifoveal area.