Comparison of the anatomical, topographic and refractive shift in the eyes after the penetrating and non-penetrating glaucoma surgery

PURPOSE: To compare the biometric, biomechanic and keratorefractive shift after trabeculectomy and non-penetrative deep sclerectomy (NPDS).

METHODS: 45 patients after trabeculectomy and 45 patients after NPDS were included into the study. The patients were examined prior to surgery, one week, one month and three months after the surgery. Patients underwent tonometry and measurements of corneal biomehanic properties, axial length (AL), anterior chamber depth (ACD), lens thickness and pupil width. Keratorefractometry was performed to define refractive data and corneal curvature in the steep meridian (R1), flat meridian (R2), the average curvature (Ave), and the corneal cylinder.

RESULTS: The changes of intraocular pressure, biomechanical and refractive properties after trabeculectomy and NPDE were comparable. The following parameters were statistically different between two groups: during the first week — ACD (2.39 [1.95; 2.65] mm after trabeculectomy, 2.62 [2.33; 2.89] mm after NPDE); by the end of the first month — ACD (2.42 [2.24; 2.70] mm after trabeculectomy, 3.11 [2.68; 3.17] mm after NPDE), AL (23.70 [22.70; 24.11] mm after trabeculectomy, 25.11 [23.95; 26.25] mm after NPDE), R1 (7.53 [7.36; 7.70] mm after trabeculectomy, 7.93 [7.89; 8.05] mm after NPDE), and average curvity (7.47 [7.27; 7.65] mm after trabeculectomy, 7.88 [7.60; 7.92] mm after NPDE). No significant intergroup differences were noted by the end of the third month of follow-up. It is also worth noting, that a correlation between refraction shift with astigmatism development and corneal resistance change was observed in the NPDE group.

CONCLUSION: Significant differences between eyes after trabeculectomy and NPDE can be found in ACD values one week post-surgery and in ACD, AL and cornea curvature by the end of the first month. Refraction shift and astigmatism development after NPDE depends on the initial biomechanical properties of the cornea.

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