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Purpose: To evaluate the efficacy and safety of anterior segment optical coherence tomography (AS-OCT) for diagnosing ciliary body detachment (CBD) during the early period following trabeculectomy for primary angle closure glaucoma (PACG), and to document the incidence of CBD and relative factors.
Methods: Perspective, cross-sectional study.A total of 87 eyes of 66 PACG patients who had undergone trabeculectomy in our hospital from May 2010 to February 2011. Pre-operative ultrasound biomicroscopy (UBM), B-scan ultrasonography, and AS-OCT examinations confirmed that there was no pre-existing CBD, choroidal detachment (CD), or retinal detachment (RD). Records were made of pre- and post-operative intraocular pressure (IOP), as well as differences between them. Also documented were the number of pre-surgical medications, pre-surgical axial length (AL), and cup/disc ratio (C/D). Observed complications, e.g., hyphema, infection, and shallow anterior chamber (AC), were recorded. AS-OCT and B-scans were used to examine eyes 2–3 days after surgery to determine the existence of CBD and CD.
Results: One PACG eye was excluded because of the existence of CBD prior to surgery. Sixty-five cases (86 eyes) were evaluated statistically. No eye became infected. CDB and CD incidence were expectively 48.7%, 17.0% in acute PACG (APACG), 43.6%, 10.3% in chronic PACG (CPACG). There was no statistical difference in the incidence of CBD (p=0.621) and CD (p=0.804) between APACG and CPACG groups. All eyes with CD had CBD. There are no differences except the degree of CBD between eyes with only CBD and eyes with both CBD and CD (APACG, p=0.010; CPACG, p=0.003). Post-operative IOP in eyes with CBD (APACG, 7.73±2.57mmHg; CPACG, 7.34±2.25mmHg ) was lower than in eyes without CBD (APACG, 10.45±4.84mmHg, p=0.013; CPACG, 12.10±5.26mmHg, p=0.001 ). pre- and post-operative differences in IOP were greater in eyes with CBD (35.33±13.46mmHg) than in eyes without (24.15±16.36mmHg, p=0.014) in APACG.
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