Changes in peripapillary retinal nerve fiber layer thickness in chronic glaucoma and non-glaucoma patients after phacoemulsification cataract surgery
Background: Phacoemulsification is a common cataract operation nowadays. During phacoemulsification, variation in intraocular pressure (IOP) may occur, which might change the retinal nerve fiber layer (RNFL) thickness. This study was aimed to evaluate the change in peripapillary RNFL thickness and mean deviation (MD) of visual field after phacoemulsification in chronic primary glaucoma and non-glaucoma patients.
Methods: Cohort prospective study was done on 26 patients (13 chronic glaucoma eyes and 13 non-glaucoma eyes) who underwent phacoemulsification. The changes in peripapillary RNFL thickness and MD of visual field were measured as the primary outcome. Comparison between pre- and post-surgery was analyzed with paired t-test, while unpaired t-test was used for comparison between groups.
Results: There were no significant changes in RNFL thickness on both groups. Average RNFL thickness in glaucoma group before and after phacoemulsification were 94.9±20.0 μm and 99.1±21.3 μm, respectively (p>0.05). Average RNFL thickness in non-glaucoma group were 100.2±11.1 μm and 101.7±6.8 μm, respectively (p>0.05). Glaucoma patients yielded decreasing mean deviation (MD) of visual field, but it was not statistically significant (p=0.071). In contrast, the MD of visual field after surgery was significantly increased in non-glaucoma group (p=0.005).
Conclusion: Phacoemulsification tended to increase peripapillary RNFL thickness in glaucoma or non-glaucoma patients. The visual field tended to decrease in glaucoma patients, but was significantly increased in non-glaucoma patients.
Levin LA. Pathophysiology of the progressive optic neuropathy of glaucoma. Ophthalmol Clin North Am. 2005;18(3):355–64. http://dx.doi.org/10.1016/j.ohc.2005.05.010
Rao HL, Babu JG, Addepalli UK, Senthil S, Garudadri CS. Retinal nerve fiber layer and macular inner retina measurements by spectral domain optical coherence tomograph in Indian eyes with early glaucoma. Eye (Lond). 2012;26(1),133–9. http://dx.doi.org/10.1038/eye.2011.277
Sung KR, Kim DY, Park SB, Kook MS. Comparison of retinal nerve fiber layer thickness measured by Cirrus HD and Stratus optical coherence tomography. Ophthalmology. 2009;116(7):1264–70. http://dx.doi.org/10.1016/j.ophtha.2008.12.045
Schuman JS, Hee MR, Puliafito CA, Wong C, Pedut-Kloizman T, Lin CP, et al. Quantification of nerve fiber layer thickness in normal and glaucomatous eyes using optical coherence tomography. Arch Ophthalmol. 1995;113(5):586–96. http://dx.doi.org/10.1001/archopht.1995.01100050054031
American Academy of Ophthalmology. Fundamentals and principles of ophthalmology: basic and clinical science course. San Francisco: American Academy of Ophthalmology; 2006–2007.
Chen D, Zhu J, Li J, Ding XX, Lu F, Zhao YE. Effect of simulated dynamic intraocular pressure on retinal thickness measured by optical coherence tomography after cataract surgery. Int J Ophthalmol. 2012;5(6):687–93. http://dx.doi.org/10.3980/j.issn.2222-3959.2012.06.07
Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90(3):262-7. http://dx.doi.org/10.1136/bjo.2005.081224
Faiqoh M. Karakteristik pasien di divisi glaukoma poliklinik mata Rumah Sakit Cipto Mangunkusumo tahun 2001–2010 Jakarta: Indonesia; 2011. Indonesian
Wang YX, Xu L, Yang H, Jonas JB. Prevalence of glaucoma in North China: the Beijing eye study. Am J Ophthalmol. 2010;150(6):917–24. http://dx.doi.org/10.1016/j.ajo.2010.06.037
Giangiacomo A, Coleman AL. The epidemiology of glaucoma In: Grehn F, Stamper R, editors. Glaucoma. Heidelberg: Springer; 2009. p. 13–21. http://dx.doi.org/10.1007/978-3-540-69475-5_2
Liu X, Zhong YM, Xiao H, Huang JJ, Kong XY. The damage patterns of retinal nerve fiber layer in acute and chronic intraocular pressure elevation in primary angle closure glaucoma. Eye Sci. 2011;26(3):154–60. http://dx.doi.org/ 10.3969/j.issn.1000-4432.2011.03.006.
Tsai JC, Lin PW, Teng MC, Lai IC. Longitudinal changes in retinal nerve fiber layer thickness after acute primary angle closure measured with optical coherence tomography. Invest Ophthalmol Vis Sci. 2007;48(4):1659–64. http://dx.doi.org/10.1167/iovs.06-0950
Schuman JS. Spectral domain optical coherence tomography for glaucoma (An AOS Thesis). Trans Am Ophthalmol Soc. 2008;106:426–58.
Yoles E, Schwartz M. Potential neuroprotective therapy for glaucomatous optic neuropathy. Surv Ophthalmol. 1998;42(4):367–72. http://dx.doi.org/10.1016/S0039-6257(97)00123-9
Pardianto G, Moeloek N, Reveny J, Wage S, Satari I, Sembiring R, et al. Retinal thickness changes after phacoemulsification. Clin Ophthalmol. 2013;7:2207–14. http://dx.doi.org/10.2147/OPTH.S53223
Lee DW, Kim JM, Park KH, Choi CY, Cho JG. Effect of media opacity on retinal nerve fiber layer thickness measurements by optical coherence tomography. J Ophthalmic Vis Res. 2010;5(3):151–7.
Dada T, Behera G, Agarwal A, Kumar S, Sihota R, Panda A. Effect of cataract surgery on retinal nerve fiber layer thickness parameters using scanning laser polarimetry (GDxVCC). Indian J Ophthalmol: 2010;58(5):389–94. http://dx.doi.org/10.4103/0301-4738.67048
Gazzard G, Foster PJ, Devereux JG, Oen F, Chew P, Khaw PT, et al. Intraocular pressure and visual field loss in primary angle closure and primary open angle glaucomas. Br J Ophthalmol. 2003;87(6):720–5. http://dx.doi.org/10.1136/bjo.87.6.720
Cheung CY, Leung CK, Lin D, Pang CP, Lam DS. Relationship between retinal nerve fiber layer measurement and signal strength in optical coherence tomography. Ophthalmology. 2008;115(8):1347–51. http://dx.doi.org/10.1016/j.ophtha.2007.11.027
Copyright (c) 2015 Olivia P. Perdana, Andi A. Victor, Virna D. Oktarina, Joedo Prihartono
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.