| Abstract [eng] |
The lamina cribrosa (LC) is known to be the principal site of glaucomatous damage. All morphologic parameters describing the biomechanics of LC in relation to intraocular pressure (IOP) are of great importance to provide insights into the fundamental mechanisms of glaucoma pathogenesis, diagnosis and treatment. The aim of this study was to evaluate morphologic changes of the LC in glaucoma-affected eyes after IOP reduction following trabeculectomy as well as to assess their relationship to biometric and clinical ocular parameters. The prospective longitudinal study included 112 patients (118 eyes) with glaucoma undergoing trabeculectomy. The LC was imaged using spectral-domain optical coherence tomography before trabeculectomy and during 6 follow-up visits throughout the first postoperative year. The postoperative mean and sectoral LC depth, nasal-temporal and superior-inferior curvatures, and global shape index (GSI) were assessed. In most eyes, trabeculectomy resulted in long-term flattening and shallowing of the LC. However, in some cases, LC deepened from baseline, revealing bidirectional behaviour after the surgery. Change in LC global shape appeared to be temporal. Greater biomechanical response of the lamina cribrosa to trabeculectomy was associated with younger age, greater IOP reduction, postoperative axial length shortening and choroidal and macular thickening. Greater morphologic changes of the lamina cribrosa after trabeculectomy were significantly related to structural and functional glaucoma progression, with the relationship being influenced by the severity of the disease. |
