Optic disc topography before and after trabeculectomy in advanced glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Outcomes

Background:

• Filtration surgery is a common treatment for glaucoma.
• Optic disc topography changes are indicative of glaucoma progression.
• Assessing the impact of surgery on optic disc morphology is essential.

Purpose of the Study:

• To analyze changes in optic disc topography following filtration surgery.
• To correlate intraocular pressure (IOP) reduction with optic disc changes.
• To evaluate the long-term effects of filtration surgery on glaucomatous optic neuropathy.

Main Methods:

• Laser scanning tomography was used to assess optic disc topography.
• The study included 10 eyes (9 patients) at 3.7 months and 8 eyes (7 patients) at 13.1 months post-surgery.
• Intraocular pressure (IOP) was measured preoperatively and at multiple postoperative time points.

Main Results:

• Postoperative IOP significantly decreased from a mean of 24.4 mmHg preoperatively to 11.0 mmHg at 3.7 months and 13.6 mmHg at 13.1 months.
• A >30% IOP reduction was achieved in most eyes initially, with sustained reduction in 6 of 8 eyes at 13.1 months.
• Eyes with significant IOP reduction showed a >30% decrease in optic disc cup volume, while those without showed slight increases.

Conclusions:

• Sustained reduction in intraocular pressure after filtration surgery can lead to reversal of optic disc topography changes.
• Maintaining sufficiently low postoperative IOP is critical for improving optic disc structure in glaucoma patients.
• Filtration surgery offers a potential for structural improvement of the optic nerve in glaucoma management.