Supraciliochoroidal fluid incidence at the early stage after trabeculectomy: study with anterior segment optical coherence tomography.

PURPOSE

To analyze the appearance of supraciliochoroidal fluid (SCF) within 1 week after trabeculectomy with anterior segment optical coherence tomography (AS-OCT), a high-resolution, non-contact detection method.

METHODS

In this prospective, non-comparative study, AS-OCT was used to assess the incidence of SCF in 25 eyes of 22 glaucoma patients who underwent trabeculectomy. Eyes were examined for SCF before and at 1, 3 days, and 1 week after surgery. Eyes with SCF were additionally examined at 2, 3, 4, and 8 postoperative weeks. Eyes were examined for the intraocular pressure (IOP), central depth of anterior chamber, and anterior inflammation.

RESULTS

None of the 25 eyes displayed preoperative SCF. Postoperative SCF was found in 19 eyes (76%), which first appeared on day 1 (10/19), day 3 (5/19), or 1 week (4/19) after surgery. Diagnoses of the 19 eyes included primary open-angle glaucoma (8 eyes), chronic primary angle-closure glaucoma (5 eyes), acute primary angle closue glaucoma (5 eyes), and secondary glaucoma (1 eye). SCF was found in four (16 eyes, 84.2%), two (2 eyes, 10.5%), or one quadrant (1 eye, 5.3%). Most of the 19 eyes displayed grade I (10 eyes, 52.6%) or grade II detachment (8 eyes, 42.1%), with 1 eye (5.3%) showing grade III detachment. The lowest IOP was lower in eyes with SCF (4.3 ± 2.7 mmHg) than in those without (16.3 ± 6.0 mmHg) (p = 0.000). The IOP rose from 7.55 ± 4.33 mmHg at SCF detection to 13.47 ± 5.52 mmHg at SCF disappearance (p = 0.009). Most eyes (17 eyes, 89.5%) had displayed no SCF by week 4, but one eye still displayed SCF at 8 postoperative weeks.

CONCLUSIONS

At the very early stages after trabeculectomy (within 1 postoperative week), SCF was detected frequently with AS-OCT. Compared with previous reports using other detection methods, AS-OCT diagnosed postoperative SCF more frequently and at earlier time points.