Refractive and axial length changes after trabeculectomy for open angle glaucoma

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PurposePredicting refractive and axial changes that might occur after glaucoma surgery should be taken into account when managing the patients that have had cataract surgery previously or at the time of trabeculectomy (combined procedures). The aim of our study is to provide data regarding the changes in refraction and axial length (AL) at one year follow-up after trabeculectomy for open angle glaucoma.MethodsThis is a retrospective study assessing 48 patients that underwent trabeculectomy; 27 patients underwent cataract surgery at minimum 12 months after glaucoma surgery. Refractive status was analyzed using auto-refractometry and axial length was measured using non-contact biometry prior to the surgery and at one year follow-up. Primary outcomes were axial length, refractive status and intraocular pressure (IOP).ResultsThe difference between the mean final refraction and mean preoperative refraction in the study group (-0.68±1.05 D vs -0.47±0.86 D) was not statistically significant (P=0.215). At one year follow-up, IOP was significantly reduced after trabeculectomy with a mean of 8.95 +/- 2.93 mmHg (p = 7.82x10-13). AL was determined at six months and one year follow-up; the mean AL was significantly reduced at all time points (0.10 and 0.08 respectively; p value 0.015).ConclusionThe axial length reduction after trabeculectomy is small though still statistically significant. The decrease in axial length postoperatively was also correlated with the degree of IOP reduction. Following trabeculectomy the refractive status of the eye remained unchanged.

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