The Changes of Corneal High-Order Aberrations and Anterior Chamber Parameters after Trabeculectomy Using Pentacam

Byoung Seon Kim; Byung Jae Kim; In Young Chung; Seong Wook Seo; Ji Myong Yoo; Seong Jae Kim

doi:10.3341/jkos.2014.55.5.662

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Kim, Kim, Chung, Seo, Yoo, and Kim: The Changes of Corneal High-Order Aberrations and Anterior Chamber Parameters after Trabeculectomy Using Pentacam

Original Article

J Korean Ophthalmol Soc 201;55(5):662-668.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.5.662

The Changes of Corneal High-Order Aberrations and Anterior Chamber Parameters after Trabeculectomy Using Pentacam

Byoung Seon Kim, MD¹, Byung Jae Kim, MD¹, In Young Chung, MD, PhD^1,², Seong Wook Seo, MD, PhD^1,², Ji Myong Yoo, MD, PhD^1,², Seong Jae Kim, MD, PhD^1,²

¹Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea

²Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea

Address reprint requests to Seong Jae Kim, MD, PhD, Department of Ophthalmology, Gyeongsang National University Hospital, #79 Gangnam-ro, Jinju 660-702, Korea, Tel: 82-55-750-8171, Fax: 82-55-758-4158, E-mail: maya12kim@naver.com

Received 13 September 2013 Revised 27 November 2013 Accepted 18 April 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate changes in corneal keratometry, high-order aberrations (HOAs), and anterior chamber parameters after trabeculectomy using Pentacam® (Oculus Inc., Dutenhofen, Germany).

Methods

Forty eyes of 40 patients who underwent limbal-based trabeculectomy or fornix-based trabeculectomy between July 2011 and May 2012 were retrospectively reviewed. Intraocular pressure (IOP), corneal keratometry, central corneal thickness, anterior chamber depth, anterior chamber volume, and HOAs were measured using Pentacam® preoperatively and at 3 months postoperatively.

Results

The mean age of patients who underwent trabeculectomy was 58.26 ± 16.28 years. IOP showed significant decrease after surgery in both groups compared to preoperative values (p < 0.05). There were no significant differences in corneal keratometry, anterior chamber depth, anterior chamber volume, central corneal thickness, total root mean square (RMS), trefoil, and coma after surgery (p > 0.05).

Conclusions

Postoperative corneal keratometry and anterior chamber parameters did not change significantly compared to preoperative values in glaucoma patients after performing trabeculectomy. Most HOAs that affected quality of vision were not changed in the limbal-based trabeculectomy or fornix-based trabeculectomy.

Keywords: Cornea, High-order aberration, Keratometry, Trabeculectomy

References

1. Applegate RA, Howland HC, Sharp RP, et al. Corneal aberrations and visual performance after radial keratotomy. J Refract Surg. 1998; 14:397–407.

2. Oshika T, Klyce SD, Applegate RA, et al. Comparison of corneal wavefront aberrations after photorefractive keratectomy and laser in situ keratomileusis. Am J Ophthalmol. 1999; 127:1–7.

3. Marcos S. Aberrations and visual performance following standard laser vision correction. J Refract Surg. 2001; 17:S596–601.

4. Cunliffe IA, Dapling RB, West J, Longstaff S. A prospective study examining the changes in factors that affect visual acuity following trabeculectomy. Eye (Lond). 1992; 6:618–22.

5. Cunliffe IA, Dapling RB, West J, Longstaff S. The effect of trabeculectomy on corneal topography. Ophthalmic Surg. 1993; 24:135.

6. Claridge KG, Galbraith JK, Karmel V, Bates AK. The effect of trabeculectomy on refraction, keratometry and corneal topography. Eye (Lond). 1995; 9:292–8.

7. Dietze PJ, Oram O, Kohnen T, et al. Visual fuction following trabeulcectomy : effect on corneal topography and contrast sensitivity. J Glaucoma. 1997; 6:99–103.

8. Vernon SA, Zambarakji HJ, Potgieter F, et al. Topographic and keratometric astigmatism up to 1 year following small flap trabeculectomy (microtrabeculectomy). Br J Ophthalmol. 1999; 83:779–82.

9. Kook MS, Kim HB, Lee SU. Short-term effect of mitomycin-C augmented trabeculectomy on axial length and corneal astigmatism. J Cataract Refract Surg. 2001; 27:518–23.

10. Hong YJ, Choe CM, Lee YG, et al. The effect of mitomycin-C on postoperative corneal astigmatism in trabeculectomy and a triple procedure. Ophthalmic Surg Lasers. 1998; 29:484–9.

11. Kadowaki H, Mizoguchi T, Kuroda S, et al. Surgically-induced astigmatism following single-site phacotrabeculectomy, phacotrabeculotomy and advanced non-penetrating phacotrabeculectomy. Semin Ophthalmol. 2001; 16:158–61.

12. Egrilmez S, Ates H, Nalcaci S, et al. Surgically induced corneal refractive change following glaucoma surgery: nonpenetrating trabecular surgeries versus trabeculectomy. J Cataract Refract Surg. 2004; 30:1232–9.

13. Fukuoka S, Amano S, Honda N, et al. Effect of trabeculectomy on ocular and corneal higher order aberrations. Jpn J Ophthalmol. 2011; 55:460–66.

14. Rosen WJ, Mannis MJ, Brandt JD. The effect of trabeculectomy on corneal topography. Ophthalmic Surg. 1992; 23:395–8.

15. Hugkulstone CE. Changes in keratometry following trabeculectomy. Br J Ophthalmol. 1991; 75:217–8.

16. Young Ji Lee, Samin Hong, Chan Yun Kim, Gong Je Seong. Comparison of surgically induced corneal astigmatism following trabeculectomy and deep sclerectomy with collagen implant. J Korean Ophthalmol Soc. 2012; 53:94–102.

17. Francis BA, Wang M, Lei H, et al. Changes in axial length following trabeculectomy and glaucoma drainage device surgery. Br J Ophthalmol. 2005; 89:17–20.

Table 1.

Patient characteristics for trabeculectomy

Characteristics	Total	Trabeculetomy
Characteristics	Total	Limbal based (n = 20)	Fornix based (n = 20)
Mean age (years)	58.26 ± 16.28	56.57 ± 15.28	59.25 ± 18.28
Sex
Male	30	12	18
Female	10	8	2
Diagnosis
POAG	31	15	16
CACG	5	2	3
2ndOAG	4	3	1
Lens status
Phakic	29	15	14
Pseudophakic	11	5	6
Aphakic	0	0	0

Values are presented as mean ± SD.

POAG = primary open angle glaucoma; CACG = chronic angle closed glaucoma; 2ndOAG = secondary open angle glaucoma.

Table 2.

Changes in intraocular pressure (IOP) in mmHg, following trabeculectomy (after 3months)

	Total			Trabeculetomy
	Total			Limbal based (n=20)			Fornix based (n=20)
	Preoperative	Postoperative	p-value	Preoperative	Postoperative	p-value	Preoperative	Postoperative	p-value
Mean IOP (mm Hg)	35.22 ± 12.21	13.60 ± 6.11	0.000	32.32 ± 11.81	14.60 ± 4.21	0.000	37.62 ± 9.81	12.60 ± 2.81	0.000
Mean Number of medications(n)	2.90 ±0.82	1.08 ± 1.50	0.000	2.94 ± 0.24	1.17 ± 1.07	0.000	2.89 ± 0.38	1.02 ± 2.88	0.000

Values are presented as mean ± SD.

Table 3.

Changes in refractive error and visual acuity, following trabeculectomy (after 3months)

	Total			Trabeculetomy
	Total			Limbal based (n=20)			Fornix based (n=20)
	Preoperative	Postoperative	p-value	Preoperative	Postoperative	p-value	Preoperative	Postoperative	p-value
Spherical (D)	-0.93 ± 2.05	-0.78 ± 1.10	0.552	-0.94 ± 1.95	-0.71 ± 2.10	0.357	-0.92 ± 1.26	-0.85 ± 1.10	0.652
Cylinder (D)	-0.58 ±1.50	-0.70 ± 1.08	0.526	-0.53 ± 1.04	-0.71 ± 1.19	0.433	-0.62 ± 0.96	-0.69 ± 0.65	0.596
Visual acuity	4.86 ± 1.80	4.78 ± 0.80	0.838	4.80 ± 1.79	4.71 ± 2.04	0.799	4.90 ± 1.82	4.81 ± 1.08	0.862

Values are presented as mean ± SD; Visual acuity: 1: Light perception, 2: Hand motion, 3: <0.1, 4: 0.1-0.2, 5: 0.3-0.4, 6: 0.5-0.7, 7: 0.8-1.0.

Table 4.

Changes in anterior chamber parameters, following trabeculectomy(after 3months)

	Total			Trabeculetomy
	Total			Limbal based (n=20)			Fornix based (n=20)
	Preoperative	Postoperative	p-value	Preoperative	Postoperative	p-value	Preoperative	Postoperative	p-value
Vertical K (D)	42.21 ± 1.23	43.80 ± 1.28	0.280	43.22 ± 1.63	43.17 ± 1.32	0.105	41.98 ± 1.23	42.08 ± 1.08	0.317
Horizontal K (D)	43.12 ± 1.28	43.87 ± 1.64	0.294	43.98 ± 1.50	44.37 ± 1.74	0.496	42.58 ± 1.20	43.32 ±0.74	0.596
ACD (mm)	3.08 ±0.21	3.08 ±0.11	0.599	3.10 ± 0.81	3.07 ± 0.81	0.610	3.08 ± 0.51	3.12 ± 0.78	0.750
ACV (mm³)	154.10 ± 45.90	142.83 ± 31.80	0.180	160.10 ±43.87	148.83 ± 33.60	0.218	152.50 ±25.52	139.23 ± 13.60	0.488

Values are presented as mean ± SD.

K = keratometry; ACD = anterior chamber depth; ACV = anterior chamber volume.

Table 5.

Changes in higher order aberration, following trabeculectomy (after 3months)

	Total	Trabeculetomy
	Total	Limbal based (n=20)	Fornix based (n=20)	^†p-value
Total RMS (μm)
Preoperative	0.91 ± 0.40	0.95 ± 0.61	0.85 ± 0.25	0.253
Postoperative	0.98 ± 0.23	1.02 ± 0.53	0.93 ± 0.23	0.536
^*p-value	0.089	0.218	0.102
Coma (μm)
Preoperative	0.14 ± 0.10	0.16 ± 0.14	0.12 ± 0.14	0.123
Postoperative	0.12 ± 0.24	0.14 ± 0.07	0.11 ± 0.85	0.109
^*p-value	0.482	0.658	0.792
Trefoil (μm)
Preoperative	0.20 ± 0.16	0.23 ± 0.26	0.18 ± 0.95	0.632
Postoperative	0.21 ± 0.40	0.23 ± 0.30	0.20 ± 0.12	0.232
^*p-value	0.180	0.413	0.208
Spherical aberration (μm)
Preoperative	0.04 ± 0.05	0.02 ± 0.05	0.08 ± 0.02	0.095
Postoperative	0.05 ± 0.20	0.04 ± 0.14	0.06 ± 0.12	0.083
^*p-value	0.124	0.413	0.653

Values are presented as mean ± SD.

RMS = root mean square.

^* Mann-Whitney U-test;

^† Paired t-test.

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