Effect of Trabeculectomy on Ocular Hemodynamic Parameters in Pseudoexfoliative and Primary Open-angle Glaucoma Patients

Purpose: To evaluate the effects of trabeculectomy on ocular hemodynamic parameters in pseudoexfoliative glaucoma (PXG) and primary open-angle glaucoma (POAG) patients and to analyze serum antiphospholipid antibody levels (APLAs) in PXG.

Methods: Thirty open-angle glaucoma patients were included in the prospective study. Intraocular pressure (IOP), ocular perfusion pressure (OPP), blood pressure, and pulsatile ocular blood flow (POBF) were measured. Retrobulbar blood flow (RBF) was measured using the color Doppler imaging. Venous blood samples were obtained from PXG patients; APLAs IgG levels were assessed. The level of significance was P<0.05.

Results: IOP decreased significantly in both groups after trabeculectomy [from 30.1 (7.2) to 15.0 (5.1) in PXG; from 29.1 (7.7) to 13.1 (5.5) in POAG, P<0.05]. OPP increased from 38.9 (10.3) to 55.5 (8.6) in PXG and from 40.9 (11.0) to 56.7 (8.9) in POAG group, P<0.05. Both groups showed significant increase in CRA PSV [from 8.75 (2.27) to 9.79 (2.31) in PXG and from 8.55 (2.59) to 10.11 (2.64) in POAG, P<0.05]. Both groups showed an increase in POBF [from 13.09 (3.41) to 18.81 (5.70) in PXG and from 11.89 (5.79) to 19.29 (9.02) in POAG, P<0.05). Patients with normal APLAs levels showed significant decrease in IOP [from 30.7 (8.1) to 15.2 (5.9)] and increase in POBF [from 13.24 (3.69) to 19.94 (5.03)], CRA PSV [from 8.78 (2.39) to 9.46 (2.17)], and tSPCA PSV [from 7.61 (2.15) to 8.35 (1.98)], P<0.05.

Conclusions: Trabeculectomy resulted in a significant decrease in IOP and increase in ocular blood flow. Effects of trabeculectomy in PXG patients were significantly less compared with POAG. Patients with normal APLA levels had a significant increase in ocular hemodynamic parameters compared with patients with higher APLAs levels.