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Abstract #53748 Published in IGR 15-2

Longitudinal changes in anterior chamber depth and axial length in Asian subjects after trabeculectomy surgery

Husain R; Li W; Gazzard G; Foster PJ; Chew PT; Oen FT; Phillips R; Khaw PT; Seah SK; Aung T
British Journal of Ophthalmology 2013; 97: 852-856

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BACKGROUND/AIMS: To investigate longitudinal changes in anterior chamber depth (ACD) and axial length (AXL) over 5 years after trabeculectomy surgery in Asian patients with primary glaucoma, and to identify factors associated with these changes. METHODS: In this prospective cohort study, phakic subjects with primary glaucoma who underwent trabeculectomy had ACD and AXL measured over 5 years. The effect of intraocular pressure (IOP) on ACD and AXL was determined. Subjects were divided into two groups (high or low fluctuation of ACD/AXL) and factors were compared to determine if there were factors associated with greater fluctuation. RESULTS: 122 subjects were analysed. The majority of subjects were male (75.4%) and Chinese (77%). ACD and AXL were shallower/shorter compared with baseline at all postoperative visits, with a mean decrease of 0.11 mm (95% CI 0.07 to 0.15 mm, p<0.01) and 0.16 mm (95%CI 0.11 to 0.20 mm, p<0.01), respectively. Patients with primary open angle glaucoma (POAG) had higher odds of fluctuations in longitudinal measurements of ACD (OR=8.74, p<0.01) and AXL (OR=5.60, p<0.01) compared with patients with primary angle closure glaucoma. For every 1 mm Hg decrease in IOP, ACD and AXL decreased by 0.02 mm (p<0.01) and 0.01 mm (p=0.03), respectively, for POAG patients with emmetropia or mild myopia. CONCLUSIONS: Trabeculectomy resulted in a decrease in both ACD and AXL, and these changes were persistent over a period of 5 years.

Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.

Full article

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Classification:

12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
2.4 Anterior chamber angle (Part of: 2 Anatomical structures in glaucoma)
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)

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