Abstract
Purpose::
to investigate the effect of deep sclerectomy and trabeculectomy on intraocular pressure, retrobulbar haemodynamics and ocular surface temperature.
Methods::
41 eyes of 41 patients with primary open angle glaucoma were included in the study; 22 underwent deep sclerectomy, 19 trabeculectomy. The eyes were examined prior to surgery and at 1 and 3 months after surgery. Intraocular pressure (IOP) was measured by Goldmann applanation tonometry. The peak systolic velocity (PSV), the end-diastolic velocity (EDV), and the resistivity index (RI) of ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCAs) were evaluated by means of color Doppler imaging (CDI). The ocular surface temperature was measured using infrared thermography. Statistical analysis was performed by Student’s t test, ANOVA for repeated observations, and linear regression; a p value of ≤0.01 was considered significant.
Results::
IOP values were decreased in both deep sclerectomy and trabeculectomy groups (p<0.001) at 1 and 3 months. At the same time points, CDI measurements showed increased EDV of OA in both groups (p<0.001 for deep sclerectomy, p=0.005 for trabeculectomy), of CRA in trabeculectomy group (p<0.001) and of SPCAs in both groups (p<0.001), and decreased RI of OA, CRA, and SPCAs in both groups (p<0.001). At the 3-month examination, a positive correlation was found between IOP values and IR of OA following trabeculectomy (r=0.559, p=0.01). Ocular temperature measurements at 3 months showed a significant increase from presurgical data (p=0.002 for deep sclerectomy, p<0.001 for trabeculectomy). At the same time point, ocular temperature correlated negatively with RI of OA in deep sclerectomy and trabeculectomy groups (r=0.906, p<0.001, and r=0.626, p=0.01, respectively), of CRA (r=0.564, p=0.006, and r=0.563, p=0.01, respectively), and of SPCAs (r=0.572, p=0.005, and r=0.598, p=0.006, respectively).
Conclusions::
deep sclerectomy and trabeculectomy are both effective in lowering IOP and in improving retrobulbar haemodynamics. A correlation between postoperative IOP values and CDI parameters was present in trabeculectomy group. A relationship between ocular surface temperature and retrobulbar haemodynamics following glaucoma surgery was suggested.