First Author: M.Pakravan IRAN
Co Author(s): M. Afroozifar S. Yazdani
Purpose:
To assess corneal biomechanics changes after trabeculectomy + Mitomycin C (MMC), phacoemulsification + trabeculectomy + posterior chamber intraocular lens implantation + MMC (PT), Ahmed glaucoma valve (AGV) implantation + MMC and phacoemulsification (PE).
Setting:
labbafinejad department of ophthalmology Tehran Iran
Methods:
In a prospective study on 63 glaucomatous eyes of 63 subjects who underwent trabeculectomy + MMC, PT + MMC, or AGV implantation + MMC and 27 eyes of 27 subjects who underwent PE, ocular response analyzer (ORA) was done before operation and then 1 and 3 months after operation. The changes in corneal hysteresis (CH) and corneal resistance factor (CRF) were analyzed. Patients with postoperative intraocular pressure (IOP) more than 21mmHg and less than 5 mmHg and patients with surgical complications were excluded.
Results:
In glaucomatous patients preoperative CH was less than non-glaucomatous patients (p<0.001). Preoperative CH was 5.37, 5.36, and 5.22 mmHg in trabeculectomy, PT and AGV groups respectively, and 8.13 mmHg in PE group (p<0.001). Postoperatively CH increased significantly in glaucoma group especially in subjects with IOP drop of more than 10 mmHg (p<0.001). After 3 months postoperatively the mean CH changes were +2.16, +2.29, and+2.30 mmHg in trabeculectomy, PT, and AGV groups respectively (all Ps ?0.001); and +0.11 mmHg in PE group (p 0.001). Postoperative CRF didnt show significant changes by each type of surgeries (all ps<0.001).
Conclusions:
In glaucomatous patients CH is less than non-glaucomatous patients and it increases significantly after glaucoma surgeries especially when IOP drops more than 10 mmHg. This change might have a significant effect on IOP measurement and should be considered in patients with history of glaucoma surgeries. FINANCIAL DISCLOSURE?: No
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