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Corneal biomechanical changes after trabeculectomy with mitomycin C in primary open-angle glaucoma and pseudoexfoliation glaucoma

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Abstract

Purpose

This study aimed to examine the effect of trabeculectomy with mitomycin C on corneal biomechanical characteristics in PEXG and POAG patients.

Methods

In this prospective comparative case series study, 32 glaucoma patients of whom 17 patients were suffering from PEXG and 15 patients from POAG were enrolled. All patients underwent complete ocular examination, CCT using ultrasound pachymetry and corneal biomechanical study using ORA. The patients were hospitalized, and trabeculectomy surgery with mitomycin was done. Three months after surgery, patients were examined and ORA was obtained again.

Results

The mean CH in patients with PEXG was lower compared to patients with POAG (5.66 ± 1.13, 7.49 ± 0.88, respectively) before surgery, which had a statistically significant difference (P < 0.001). CRF in patients with PEXG was significantly lower compared to patients with POAG (8.19 ± 1.48 vs. 9.35 ± 1.60, respectively) before surgery, with P = 0.049. CH remarkably increased and reached 6.69 ± 0.78 (P < 0.001) in the PEXG group after TBX + MMC surgery. CH increased in the POAG group after TBX + MIC surgery and reached 8.23 ± 1.09, which was statistically significant (P = 0.001). There was a significant relationship between CH and IOPg changes in both PEXG and POAG groups (P < 0.001 and P = 0.01, respectively). Although TBX + MMC surgery changed the amount of CH in PEXG and POAG groups, no significant difference was shown in the parameters between the two groups comparing the CH changes (P = 0.33).

Conclusion

According to the results of this study, the biomechanical characteristics of cornea, particularly CH, shows certain changes following surgery and is increased, reflecting the dynamic nature of these parameters. Our knowledge of the biomechanical changes after glaucoma surgery can help us better understand the pathophysiology of glaucoma diseases and make the right decisions for follow-up of the patients.

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Acknowledgement

We would like to thank the education deputy that sponsored us to fulfill the project in the form of thesis research. Our next thanks go to all the patients who cooperated in this study.

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Authors and Affiliations

  1. Nikookari Hospital (Eye Center), Tabriz University of Medical Sciences, Tabriz, Iran

    Rana Sorkhabi, Farhad Najafzadeh, Mohamadhosein Ahoor & Ali Mahdavifard

  2. Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

    Ali Sadeghi

Authors
  1. Rana Sorkhabi
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  2. Farhad Najafzadeh
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  3. Ali Sadeghi
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  4. Mohamadhosein Ahoor
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Corresponding author

Correspondence to Farhad Najafzadeh.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Tabriz University of medical science ethical committee and with the 1964 Declaration of Helsinki and its later amendments.

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Written informed consent was obtained from all patients after giving a full description.

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Sorkhabi, R., Najafzadeh, F., Sadeghi, A. et al. Corneal biomechanical changes after trabeculectomy with mitomycin C in primary open-angle glaucoma and pseudoexfoliation glaucoma. Int Ophthalmol 39, 2741–2748 (2019). https://doi.org/10.1007/s10792-019-01118-4

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  • DOI: https://doi.org/10.1007/s10792-019-01118-4

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