Relationship Between Preoperative High Intraocular Pressure and Retinal Nerve Fibre Layer Thinning After Glaucoma Surgery
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Recent reports show varying results regarding peripapillary retinal nerve fibre layer (RNFL) thickness after intraocular pressure (IOP)-lowering glaucoma surgery. We hypothesised that different levels of the preoperative IOP influence RNFL thickness. A total of 60 patients (60 eyes) with glaucoma, who underwent glaucoma surgery and had a stable postoperative mean IOP < 22 mmHg, were enrolled. The RNFL thickness was measured using spectral domain optical coherence tomography, before and at 3-6 months after surgery. The preoperative peak IOP, 37.4 ± 10.8 mmHg, decreased to a postoperative mean IOP of 14.8 ± 3.5 mmHg (p < 0.001). The average RNFL thickness was significantly reduced from 75.6 ± 17.7 μm to 70.2 ± 15.8 μm (p < 0.001). In subgroup analyses, only patients with a preoperative peak IOP ≥ median value (37 mmHg) exhibited significant RNFL thinning (9.7 ± 6.6 μm, p < 0.001) associated with a higher preoperative peak IOP (r = 0.475, p = 0.008). The RNFL thinning was evident for a few months after glaucoma surgery in patients with a higher preoperative peak IOP, although the postoperative IOP was stable.
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