Dynamics of changes in morphometric parameters of the macular zone in glaucoma patients after phacoemulsification

Abstract

Purpose — to analyze the dynamics of morphometric changes in the macular zone using optical coherence tomography (OCT) data in patients with primary open-angle glaucoma (POAG) after phacoemulsification (PE). Material and methods. The study enrolled 93 patients (95 eyes) requiring PE; they were divided into 2 groups. The first (control) group consisted of 30 patients (32 eyes) without concomitant eye pathology. The second group included 63 patients (64 eyes) with POAG and IOP stabilized by eye drops. In the 2A subgroup (32 eyes) patients used prostaglandin analogues, in the 2B subgroup (31 eye) — carbonic anhydrase inhibitors. OCT was used to analyze retinal thickness and volume. OCT was performed before PE, after 1 week, after 1, 3, and 6 months. Results. In the control group, the volume and thickness of the retina varied within the normal range. In the 2A subgroup, signs of macular edema (ME) in the early post-operative period were noted in 6.2% of patients. In the late post-operative period, changes in the macular zone were noted in 18.7% of cases. After the treatment, ME regressed completely in 4 patients (12.5% of all cases). One patient with retinal thickness of more than 500 μm required parabulbar and intravenous injections of glucocorticoids, which resulted in ME decrease. Another patient developed epiretinal fibrosis with tractions after ME. Among the patients of subgroup 2B, a trend for increase in the volume and thickness of the macular zone was observed in 3 cases; the values stayed within the normal range, and later returned to the initial level. Conclusion. Patients with POAG develop ME after PE in 1—3 months. The use of topical prostaglandin analogues may be the reason of ME development.