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Jennifer Drechsler, Hampton Addis, Camilo Martinez, M Roni Levin, Osamah Saeedi, Sachin Kalarn, Bethany Karwoski, William Madigan, Mohamad Jaafar, Janet Alexander; Structural changes after glaucoma surgery in infants and children using ultrasound biomicrosopy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1876.
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© ARVO (1962-2015); The Authors (2016-present)
In the U.S., approximately 1 in every 10,000 babies is born with glaucoma. Angle surgery (goniotomy) and tube shunt placement serve as surgical procedures for pediatric glaucoma, both of which function to reduce eye pressure and control the physical changes of the eyes. Ultrasound biomicroscopy can be used to image the anterior segment and visualize the anatomy influenced by these procedures. This study tested the hypothesis that the two most common types of congenital glaucoma surgery (angle surgery and tube shunt placement) result in structural changes in the anterior segment that can be measured using ultrasound biomicroscopy.
This cohort study analyzed 12 eyes from six patients who underwent surgical procedures to correct congenital glaucoma (defined as onset of glaucoma prior to age 2 years), in addition to ocular imaging using ultrasound biomicroscopy (UBM). Three time points relative to surgery were assessed for 27 different parameters of the anterior segment of the eye: pre-operative glaucoma eyes (N = 5), early post-operative eyes (N = 6) and late post-operative eyes (N = 7). Measurements were made using ImageJ, an image processing program.
Comparison between the tube shunt group and angle surgery group identified statistically significant changes in 5 parameters: peripheral corneal thickness (ParaCT), ciliary body-iris contact distance (CICD), trabecular-ciliary process distance (TCPD), iris thickness 500 μm from angle (ID1), and ciliary body-iris angle (CBIA). ParaCT and CBIA showed an increase in size from the pre-operative, to early post-operative, to late post-operative images in tube shunt placement, as where these parameters showed progressive decreases over time in angle surgery. CICD, TCPD, and ID1 showed progressive increases in size from the pre-operative, to early post-operative, to late post-operative images in both procedures.
Ultrasound biomicroscopy serves as a useful tool in measuring the progressive anatomical changes from pre-operative to post-operative UBM images among individuals undergoing surgery for congenital glaucoma. Future studies will be needed to determine if these changes correlate to clinical outcomes.
This is a 2020 ARVO Annual Meeting abstract.
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