Refractive shift after glaucoma surgery

Petrov S.Iu.; Antonov A.A.; Avetisov K.S.; Volzhanin A.V.; Agadzhanyan T.M.; Aslamazova A.E.

doi:https://doi.org/10.17116/oftalma2019135052278

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Abstract:

Filtering glaucoma surgery can affect certain biometric features of the eye: it can change the axial length and anterior chamber depth, while redistribution of mechanical tensions in the fibrous tunic can alter the shape of the cornea. Among these changes that affect refraction, reshaping of corneal curvature is the principle one. Contrary to the expectations, and in contrast to changes associated with cataract surgery, glaucoma surgery led to decrease in vertical corneal radius (steepening) and development of the with-the-rule astigmatism. A number of studies helped reveal the features of corneal astigmatism that appears after glaucoma surgery: its power, duration, possibility of horizontal meridian flattening, influence of topical cytostatic drugs and drainage devices, etc. Potential reasons of astigmatism development were suggested: conjunctival incisions and sutures in the limbal area, quantity and strength of flap sutures, intraocular pressure level, shift of fistula edges, tissue contraction after cauterization, etc. The key role in pathogenesis of the refractive shift due to change of corneal curvature may belong to particularities of wound healing in the cornea and sclera: healing in sclera is similar to one of connective tissue — its ultrastructure undergoes aging process followed by change of rigidity. At the same time, the main reason for the development of corneal astigmatism after glaucoma surgery remains unclear.

Keywords:

glaucoma

sinus trabeculectomy

refraction

astigmatism

Authors:

Petrov S.Iu.

FGBU "NII glaznykh bolezneĭ" RAMN

Antonov A.A.

FGBU "NII glaznykh bolezneĭ" RAMN, Moskva

Avetisov K.S.

FGBU "NII glaznykh bolezneĭ" RAMN

SPIN RSCI: 9920-7312
Scopus AuthorID: 8298053700
ORCID: 0000-0001-9195-8908

Volzhanin A.V.

Research Institute of Eye Diseases, 11, A, B, Rossolimo St., Moscow, Russian Federation, 119021

Agadzhanyan T.M.

Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021

Aslamazova A.E.

I.M. Sechenov First Moscow State Medical University, Ophthalmology Department, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991

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