Effect of trabeculectomy and phacoemulsification combined with trabeculectomy on the ocular surface

Abstract

AIM: To compare the effects of trabeculectomy and phacotrabeculectomy on the ocular surface using ocular Keratograph 5M.METHODS: Totally 62 eyes of 62 patients with coexisting primary angle-closure glaucoma(PACG)and cataract were recruited. Thirty-two eyes accepted trabeculectomy, and the remaining thirty eyes accepted phacotrabeculectomy. Ocular surface parameters, including noninvasive first tear film break-up time(NifTBUT), noninvasive average tear film break-up time(NiaTBUT), corneal fluorescein staining scores(CFS)and tear meniscus height(TMH), were analyzed preoperatively, 3d, 1mo and 3mo postoperatively, with ocular Keratograph 5M.RESULTS: There was no significant difference in ocular surface parameters between the two groups preoperatively(P>0.05). The values of NifTBUT, NiaTBUT, CFS and TMH in phacotrabeculectomy eyes were at the worse levels, i.e. 10.13±1.48s, 12.59±1.96s, 0.80±0.22 and 0.31±0.02mm, respectively at 3d postoperatively, then improved gradually at 1mo postoperatively, but did not return to the preoperative levels at 3mo postoperatively.CONCLUSION: Ocular Keratograph 5M can be used to evaluate the changes of tear film in combined anti-glaucoma surgery accurately. The effects of phacotrabeculectomy on ocular surface are worse than that of trabeculectomy during 3mo after surgery. It is suggested that more eye care should be paid during that period of time.

Keywords

• ocular surface
• tear film break-up time
• glaucoma
• dry eye
• phacotrabeculectomy
• trabeculectomy
• ocular Keratograph 5M