Structural changes in Schlemm's canal and trabecular meshwork after phacoemulsification in patients with pseudoexfoliative glaucoma

Abstract

Purpose

To evaluate the alterations in the Schlemm's canal (SC) and trabecular meshwork (TM) morphology after phacoemulsification surgery in pseudoexfoliative glaucoma (PEXG) patients with swept-source optical coherence tomography (OCT).

Methods

In this retrospective comparative study, patients with PEXG and visually healthy individuals with cataract who underwent phacoemulsification and intraocular lens implantation surgery were included. Anterior segment OCT measurements and intraocular pressures (IOPs) were recorded at the first visit before surgery and at postoperative 1-month visits. Manual measurements obtained from OCT were as follows: SC-diameters; anteroposterior and radial SC diameter (SC-APD, SC-RD); cross-sectional area of SC (SC-CSA); and TM height (TM-H) and cross-sectional area of TM (TM-CSA).

Results

Sixty-three eyes of 63 subjects were included in the study, with 43 patients having PEXG and 20 patients serving as controls. There was a significant decrease in IOP after surgery in the PEXG eyes (p < 0.001). Preoperatively, SC-diameters were significantly lower in PEXG eyes than in the control group (p < 0.001). After surgery, SC-diameters had increased significantly in PEXG eyes (p < 0.001). At the preoperative visit, TM-CSA and TM-H were higher in PEXG eyes than in the control group, but only TM-H showed a statistically significant difference (p = 0.199 and p = 0.015, respectively). There was a significant reduction in TM-CSA and TM-H in PEXG eyes after surgery (p < 0.001 and p = 0.024, respectively).

Conclusion

The study showed that both SC dimensions and area increased and TM-H and TM-CSA decreased after phacoemulsification surgery in PEXG eyes. There was a significant correlation between these changes and postoperative IOP in PEXG eyes.

Keywords

Anterior segment optical coherence tomography phacoemulsification pseudoexfoliative glaucoma Schlemm's canal trabecular meshwork

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