Structural Changes in the Lamina Cribrosa Following Cataract Surgery in Primary Angle-Closure and Primary Open-Angle...

To evaluate the effect of cataract surgery on selected lamina cribrosa (LC) structural parameters in patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG).

In this prospective comparative study, 50 eyes of 50 patients (25 PACG, 25 POAG) undergoing cataract surgery were consecutively enrolled. Intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, and LC parameters-including lamina cribrosa thickness (LCT), lamina cribrosa depth (LCD), prelaminar depth (PLD), and prelaminar tissue thickness (PLTT)-were assessed using swept-source optical coherence tomography before and 6 months after surgery. Changes over time and between groups were analyzed using repeated measures analysis or nonparametric equivalents. Analysis of covariance was performed to adjust for postoperative IOP reduction and age.

Postoperative IOP decreased significantly in both groups (p = .003 and p = .033), with no significant difference in the magnitude of reduction between groups (p = .174). RNFL thickness did not change significantly in either group. In the PACG group, cataract surgery was associated with a significant increase in LCT (p = .01) and significant decreases in LCD (p = .002) and PLD (p < .001), whereas no significant changes were observed in the POAG group. Significant time ×group interactions were detected for LCT (p = .025), LCD (p = .017), and PLD (p = .001). PLTT did not change significantly in either group, and no significant time ×group interaction was observed (p = .09). These differences remained significant after adjustment for postoperative IOP reduction and age.

Cataract surgery was associated with measurable structural changes in the lamina cribrosa in PACG but not in POAG. Although the magnitude of IOP reduction and other ocular factors may have contributed to these findings, the structural response of the lamina cribrosa following IOP-lowering interventions may differ between glaucoma subtypes. Further studies are required to clarify the mechanisms and clinical significance of these changes.