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Long-term effects of trabeculectomy in primary open-angle glaucoma on segmented macular ganglion cell complex alterations

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Abstract

Purpose

The aim of this study is to compare, using optical coherence tomography (OCT), the changes in the thickness of the macular nerve fiber layer (mNFL), macular ganglion cell layer (mGCL), macular inner plexiform layer (mIPL) and peripapillary global retinal nerve fiber layer (gRNFL) (in a span of 3 years) in surgically treated eyes with primary open-angle glaucoma (POAG).

Methods

The medical records of 32 consecutive POAG patients who underwent trabeculectomy with mitomycin-C, between January 2013 and December 2014, were retrospectively reviewed. Pre- and postoperative measurements of IOP and OCT were analyzed 1, 2 and 3 years after the operation.

Results

Among all patients, no significant changes in the thickness of the mNFL, mGCL or mIPL were found, with a significant reduction observed only in the IOP values and peripapillary gRNFL thickness during the 3-year postoperative period. In a subgroup analysis based on the preoperative peak IOPs (median value:41 mmHg), the thickness of the mNFL, mGCL and mIPL in the 3-year postoperative period increased significantly in the lower preoperative peak IOP group (IOP < 41 mmHg), whereas the macular OCT parameters in the 3-year postoperative period decreased in the higher preoperative peak IOP group.

Conclusions

Eyes exhibiting lesser preoperative peak IOP demonstrated greater preservation of the layer-by-layer segmented macular ganglion cell complex thickness as compared to eyes exhibiting greater preoperative peak IOP; also when the IOPs determined for the two groups in the period of follow-up were quite comparable.

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Data availability

The authors declare that materials described in the manuscript, including all relevant raw data, will be freely available to any scientist wishing to use them for noncommercial purposes, without breaching participant confidentiality. Moreover, the authors ensure that their datasets are presented in the main manuscript.

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Acknowledgment

The authors would like to thank Seher Gökçe for statistical analysis, and Enago for the English language review.

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Izmir Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey

    Atılım Armağan Demirtaş

  2. Department of Ophthalmology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey

    Mine Karahan, Seyfettin Erdem, Adar Aslan Kaya & Uğur Keklikçi

  3. Department of Ophthalmology, Sultanbeyli State Hospital, Istanbul, Turkey

    Adar Aslan Kaya

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  1. Atılım Armağan Demirtaş
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  2. Mine Karahan
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  3. Seyfettin Erdem
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  5. Uğur Keklikçi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Atılım Armağan Demirtaş, Mine Karahan, Seyfettin Erdem, Adar Aslan Kaya and Uğur Keklikçi. The first draft of the manuscript was written by Atılım Armağan Demirtaş and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Atılım Armağan Demirtaş.

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Conflicts of interest

All the authors declare that they have no conflict of interest and no financial disclosure.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the Medical University of Dicle University, Diyarbakır, Turkey, (decision date: 5 December 2019, No. 282).

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Informed consent was obtained from all participants.

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Demirtaş, A.A., Karahan, M., Erdem, S. et al. Long-term effects of trabeculectomy in primary open-angle glaucoma on segmented macular ganglion cell complex alterations. Int Ophthalmol 41, 2249–2263 (2021). https://doi.org/10.1007/s10792-021-01840-y

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  • DOI: https://doi.org/10.1007/s10792-021-01840-y

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