Optical Coherence Tomography Assessment of Angle Anatomy Changes After Trabeculectomy in Primary Angle-Closure Glaucoma.

PURPOSE: Using anterior chamber optical coherence tomography to evaluate changes in angle anatomy in patients with primary angle-closure glaucoma (PACG) before and after trabeculectomy.

METHODS

This is a prospective observational study in 38 eyes of 38 patients with PACG, who underwent trabeculectomy. We used customized software to analyze optical coherence tomography images (Visante) of all participants before and after the surgical treatment. Multivariate linear regression analysis was performed for predictors of percentage change in mean angle parameters, including scleral spur angle, angle opening distance, angle recess area, and trabecular-iris surface area. The main outcome measures were changes in angle parameters and their relationship with age, sex, refraction, MD, visual outcomes, central corneal thickness, axial length of eye, number of glaucoma bottles, baseline intraocular pressure (IOP), and percentage changes in IOP (ΔIOP).

RESULTS

There was a significant increase in all angle parameters at the follow-up examination compared with the baseline value (all P<0.001). After multivariate analysis, the only variable related to changes in all angle parameters was ΔIOP.

CONCLUSIONS

Trabeculectomy results in a significant increase in the angle width in PACG. The increase in angle parameters was significantly related to the IOP changes.