Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
Invest Ophthalmol Vis Sci. 2024 Sep 3;65(11):3. doi: 10.1167/iovs.65.11.3.
This study aimed to evaluate both short-term and long-term changes in the lamina cribrosa curvature index (LCCI) following trabeculectomy and investigate the factors influencing these changes.
In this retrospective, observational study, 40 eyes of 40 patients with glaucoma who underwent trabeculectomy and had a follow-up of at least 2 years were included. Optic nerve head area was scanned by using spectral-domain optical coherence tomography before surgery (Pre_OP), within 6 months postoperatively (Post_OP1), and at the last visit (Post_OP2). LCCI values calculated from B-scan images at six different planes (0°, 30°, 60°, 90°, 120°, and 150°) and their mean values were compared. Univariate and multivariate linear regression analyses were used to identify the clinical factors associated with the amount of LCCI changes.
The mean follow-up time was 38.3 ± 16.8 months. At Post_OP1, the mean LCCI decreased from 9.28 ± 2.58 to 7.91 ± 2.57 (P < 0.001), and the mean intraocular pressure decreased from 22.0 ± 7.6 mm Hg to 12.2 ± 3.8 mm Hg (P = 0.001). At Post_OP2, the mean LCCI was maintained at 7.74 ± 2.49 (P = 0.56 when compared to Post_OP1 and P < 0.001 when compared to Pre_OP). The mean intraocular pressure was 12.6 ± 5.4 mm Hg (P = 0.67 when compared to Post_OP1 and P < 0.001 when compared to Pre_OP). Long-term LCCI changes were associated with baseline age (P = 0.04), spherical equivalent (P = 0.02), mean IOP during follow-ups (P = 0.02), and preoperative LCCI (P = 0.04).
Glaucomatous eyes undergoing trabeculectomy demonstrated reductions in the LCCI after a mean follow-up of over 3 years. Greater long-term LCCI reduction was associated with younger age, lower mean IOP during follow-up period, greater spherical equivalent refractive error, and preoperative LCCI.
本研究旨在评估小梁切除术治疗青光眼后短期和长期的小梁网嵴曲率指数（LCCI）变化，并探讨影响这些变化的因素。
这是一项回顾性观察研究，共纳入 40 例（40 只眼）接受小梁切除术并随访至少 2 年的青光眼患者。在手术前（Pre_OP）、术后 6 个月（Post_OP1）和最后一次就诊时（Post_OP2），使用频域光学相干断层扫描仪扫描视神经头区域。比较了 6 个不同平面（0°、30°、60°、90°、120°和 150°）的 B 扫描图像计算得出的 LCCI 值及其平均值。采用单变量和多变量线性回归分析来确定与 LCCI 变化量相关的临床因素。
平均随访时间为 38.3±16.8 个月。术后 1 个月时，LCCI 平均值从 9.28±2.58 降至 7.91±2.57（P<0.001），眼内压平均值从 22.0±7.6mmHg 降至 12.2±3.8mmHg（P=0.001）。术后 2 个月时，LCCI 平均值维持在 7.74±2.49（与术后 1 个月相比，P=0.56；与术前相比，P<0.001）。眼内压平均值为 12.6±5.4mmHg（与术后 1 个月相比，P=0.67；与术前相比，P<0.001）。长期 LCCI 变化与基线年龄（P=0.04）、等效球镜（P=0.02）、随访期间平均眼压（P=0.02）和术前 LCCI（P=0.04）有关。
接受小梁切除术治疗的青光眼眼在平均随访超过 3 年后，LCCI 降低。长期 LCCI 降低与年龄较小、随访期间平均眼压较低、等效球镜屈光误差较大以及术前 LCCI 较高有关。
