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Jung, Jo, and Seo: Changes in High-order Aberrations after Phacotrabeculectomy Surgery
Original Article

Journal of the Korean Ophthalmological Society 2017; 58(6): 676-684.

Published online: 16 June 2017

DOI: https://doi.org/10.3341/jkos.2017.58.6.676

Changes in High-order Aberrations after Phacotrabeculectomy Surgery

Jae Woo Jung, MD, Seong Ho Jo, MD, Je Hyun Seo, MD, PhD

Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Address reprint requests to Je Hyun Seo, MD, PhD. Department of Ophthalmology, Pusan National University Yangsan Hospital, #20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: 82-55-360-2131, Fax: 82-55-360-2161, jazmin2@naver.com

Received 15 December 2016       Revised 25 April 2017       Accepted 29 May 2017

©2017 The Korean Ophthalmological Society

(open-access):

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 investigate changes in ocular high-order aberrations (HOAs) resulting from phacotrabeculectomy and phacoemulsification.

Methods

We retrospectively reviewed 38 eyes of 38 glaucoma and cataract patients who underwent mitomycin C (MMC) augmented trabeculectomy with phacoemulsification and 34 eyes of 34 cataract patients who underwent phacoemulsifiction. For all patients, we measured the best corrected visual acuity (BCVA), intraocular pressure (IOP), keratometry, and HOAs (iTrace, Tracey Technologies, Houston, TX, USA) both preoperatively and postoperatively.

Results

IOP was significantly decreased after surgery in the combined group (p < 0.001). Entire eye, coma-like, and spherical-like high-order aberrations from each entire eye, corneal aberrations, and internal-optics aberration were increased until after 2 weeks, which then decreased until 3 months after phacotrabeculectomy. In the phacoemulsification group, entire eye (each p = 0.006, p =0.006), coma-like (each p = 0.006 and p = 0.005), and spherical-like high-order aberrations (each p = 0.008, p = 0.005) from entire eye and internal-optics aberrations were decreased.

Conclusions

After cataract surgery, entire eye, coma-like, and spherical-like high-order aberrations were significantly decreased while aberrations did not change after combined operation. These results suggest that a change in high-order aberrations of internal optics results in a decrease in postoperative HOAs. In addition, the baseline HOAs of the cataract group were higher than those of the combined surgery group, and the effect of trabeculectomy on HOAs may offset the impact of cataract surgery in the combined surgery group.

Keywords: High-order aberration, Phacoemulsification, Trabeculectomy

Figures and Tables

Figure 1

Images from topography. Change of high-order aberration, high-order aberrations were increased after three months from phacotrabeculectomy surgery (A, from 0.423 µm to 0.991 µm), and decreased after three months from phacoemulsification surgery (B, from 1.059 µm to 0.233 µm).

jkos-58-676-g001
Table 1

Demographic and baseline characterics of subjects

jkos-58-676-i001

Values are presented as mean ± SD or n (%) unless otherwise indicated. ‘Group A’ means ‘phacotrabeuculectomy’, and ‘Group B’ means ‘phacoemulsification’.

BCVA = best corrected visual acuity; IOP = intraocular pressure; DM = diabetes mellitus; HTN = hypertension; POAG = primary open angle glaucoma; NTG = normal tension glaucoma; G = glaucoma; MD = mean deviation; PSD = pattern standard deviation; N/A = not applicable.

*p-value by independent T test between group A and group B for variables, in case of numeric, Chi-square applied.

Table 2

Changes of best corrected visual acuity (BCVA), spherical equivalents (SE) and intraocular pressure (IOP) between Group A and Group B

jkos-58-676-i002

Values are presented as mean ± SD unless otherwise indicated. ‘Group A’ means ‘phacotrabeculectomy’, and ‘Group B’ means ‘phacoemulsification’.

*p-value by paired T test between baseline value and postoperative 2 weeks for each groups; †p-value by independent T test between group A and group B for variables.

Table 3

Calculation of postoperative corneal astigmatic changes (D) and postoperative corneal astigmatic changes (D) among each groups a long vertical meridian using the Cravy Method1112

jkos-58-676-i003

Values are presented as mean ± SD unless otherwise indicated. ‘Group A’ means ‘phacotrabeculectomy’, and ‘Group B’ means ‘phacoemulsification’.

D = diopters.

*p-value by paired T test between baseline value and postoperative 2 weeks for each groups; †p-value by independent T test between group A and group B for variables.

Table 4

Comparison of higher order aberrations depends on surgery and group

jkos-58-676-i004

Values are presented as mean ± SD unless otherwise indicated. ‘Group A’ means ‘phacotrabeculectomy’, and ‘Group B’ means ‘phacoemulsification’.

Coma-like = the third-order Zernike coefficients (C3-3, C3-1, C31, C33); Spherical-like = the fourth-order Zernike coefficients (C4-4, C4-2, C40, C42, C44); HOT = higher order total: magnitude of the third to sixth-orders; RMS =root mean square.

*p-value by independent T test of HOAs between Group A and Group B (Coma-like, Spherical-like, Higher order total); †p-value by paired T test between baseline value and postoperative 2 weeks for each groups (Coma-like, Spherical-like, Higher order total).

Table 5

Comparison of higher order aberrations between preoperative and postoperative in phacotrabeculectomy

jkos-58-676-i005

Values are presented as mean ± SD unless otherwise indicated. ‘Group A’ means ‘phacotrabeculectomy’.

Coma-like = the third-order Zernike coefficients (C3-3, C3-1, C31, C33); Spherical-like = the fourth-order Zernike coefficients (C4-4, C4-2, C40,C42, C44); HOT = higher order total: magnitude of the third to sixth-orders; RMS = root mean square.

*p-value by paired T test between baseline value and postoperative: 2 weeks; †p-value by paired T test between baseline value and postoperative: 1 month; ‡p-value by paired T test between baseline value and postoperative: 3 months.

Notes

This study was supported by a 2016 research grant from Pusan National University Yangsan Hospital

References

1. Delbeke H, Stalmans I, Vandewalle E, Zeyen T. The effect of trabeculectomy on astigmatism. J Glaucoma. 2016; 25:e308–e312.
2. Distelhorst JS, Hughes GM. Open-angle glaucoma. Am Fam Physician. 2003; 67:1937–1944.
3. Cairns JE. Trabeculectomy. Preliminary report of a new method. Am J Ophthalmol. 1968; 66:673–679.
4. Chu L, Zhao JY, Zhang JS, et al. Optimal incision sites to reduce corneal aberration variations after small incision phacoemulsification cataract surgery. Int J Ophthalmol. 2016; 9:540–545.
5. Applegate RA, Howland HC, Sharp RP, et al. Corneal aberrations and visual performance after radial keratotomy. J Refract Surg. 1998; 14:397–407.
6. 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.
7. Marcos S. Aberrations and visual performance following standard laser vision correction. J Refract Surg. 2001; 17:S596–S601.
8. Fukuoka S, Amano S, Honda N, et al. Effect of trabeculectomy on ocular and corneal higher order aberrations. Jpn J Ophthalmol. 2011; 55:460–466.
9. Kim BS, Kim BJ, Chung IY, et al. The changes of corneal high-order aberrations and anterior chamber parameters after trabeculectomy using Pentacam(R). J Korean Ophthalmol Soc. 2014; 55:662–668.
10. Chylack LT Jr, Wolfe JK, Singer DM, et al. The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol. 1993; 111:831–836.
11. Cravy TV. Calculation of the change in corneal astigmatism following cataract extraction. Ophthalmic Surg. 1979; 10:38–49.
12. Holladay JT, Cravy TV, Koch DD. Calculating the surgically induced refractive change following ocular surgery. J Cataract Refract Surg. 1992; 18:429–443.
13. Matsuda T, Tanihara H, Hangai M, et al. Surgical results and complications of trabeculectomy with intraoperative application of mitomycin C. Jpn J Ophthalmol. 1996; 40:526–532.
14. Seah SK, Prata JA Jr, Minckler DS, et al. Hypotony following trabeculectomy. J Glaucoma. 1995; 4:73–79.
15. 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; 27:518–523.
16. Kadowaki H, Mizoguchi T, Kuroda S, et al. Surgically-induced astigmatism following single-site phacotrabeculectomy, phacotrabeculotomy and advanced non-penetrating phacotrabeculectomy. Semin Ophthalmol. 2001; 16:158–161.
17. Mierdel P, Kaemmerer M, Krinke HE, Seiler T. Effects of photo-refractive keratectomy and cataract surgery on ocular optical errors of higher order. Graefes Arch Clin Exp Ophthalmol. 1999; 237:725–729.
18. Dietze PJ, Oram O, Kohnen T, et al. Visual function following trabeculectomy: effect on corneal topography and contrast sensitivity. J Glaucoma. 1997; 6:99–103.
19. Hong S, Park K, Ha SJ, et al. Long-term intraocular pressure control of trabeculectomy and triple procedure in primary open angle glaucoma and chronic primary angle closure glaucoma. Ophthalmologica. 2007; 221:395–401.
20. Hong S, Seong GJ, Hong YJ. Long-term intraocular pressure fluctuation and progressive visual field deterioration in patients with laucoma and low intraocular pressures after a triple procedure. Arch Ophthalmol. 2007; 125:1010–1013.
21. Sugimoto K, Ito K, Esaki K, et al. Supraciliochoroidal fluid at an early stage after trabeculectomy. Jpn J Ophthalmol. 2002; 46:548–552.
22. Hiraoka T, Miyata K, Nakamura Y, et al. Influences of cycloplegia with topical atropine on ocular higher-order aberrations. Ophthalmology. 2013; 120:8–13.
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