Abstract
This review article aimed to evaluate ocular biometric changes after trabeculectomy. The PubMed database was searched using the keywords “axial length” (AL), “anterior chamber depth” (ACD), “corneal astigmatism,” “corneal topography” and “trabeculectomy.” The extracted studies were categorized based on the evaluated parameters and the biometry method (contact and non-contact). Comparable studies with respect to their sample size were combined for statistical analysis. Twenty-five studies including 690 individuals which met the inclusion criteria were selected. After trabeculectomy, a significant and persistent AL reduction, with a range of 0.1-0.19 and 0.1-0.9 mm measured with contact and non-contact methods, respectively, was observed. With respect to topographic changes, 0.38-1.4 diopters (D) with-the-rule (WTR) astigmatism was induced postoperatively. All studies revealed ACD reduction immediately after surgery, which gradually deepened and approximated its preoperative levels on day 14. ACD reduction was not significant after that period in the majority of cases. In conclusion, changes in ACD is of small amount and of short period, thus it can be ignored; however, reported changes in AL and keratometry are of sufficient magnitude and can affect the refractive prediction of combined cataract surgery and trabeculectomy.
Highlights
Trabeculectomy, the most common surgical procedure for long‐term reduction of intraocular pressure (IOP) in glaucoma, bypasses the conventional outflow pathway by creating a corneoscleral fistula that leadsReceived: 06-11-2015Accepted: 01-01-2016Access this article onlineQuick Response Code: Website: www.jovr.org to subconjunctival bleb formation.[1,2] Maintaining the integrity of the bleb is the key factor for successful outcomes
The literature search was performed on PubMed database from its inception to April 2015 using the keywords “axial length” (AL), “anterior chamber depth” (ACD), “corneal astigmatism,” “corneal topography” and “trabeculectomy.” The research question was the relationship between ocular biometry and trabeculectomy
ACD changes following trabeculectomy were investigated in 9 studies [Table 5]
Summary
Trabeculectomy, the most common surgical procedure for long‐term reduction of intraocular pressure (IOP) in glaucoma, bypasses the conventional outflow pathway by creating a corneoscleral fistula that leadsReceived: 06-11-2015Accepted: 01-01-2016Access this article onlineQuick Response Code: Website: www.jovr.org to subconjunctival bleb formation.[1,2] Maintaining the integrity of the bleb is the key factor for successful outcomes. Intraoperative application of antimetabolites helps to meet this goal and has provided major progresses in achieving better surgical outcomes, especially in those who are at a higher risk of surgical failure.[3] Significant IOP reduction post trabeculectomy could reduce the axial length (AL) of the eye corresponding to the amount of IOP reduction.[4] Anterior chamber depth (ACD) and volume, as well as keratometry could change after the surgery These unpredictable changes may affect the accuracy of intraocular lens (IOL) power calculation in cases who need cataract surgery and IOL implantation
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