Study On Change Of Retinal Nerve Fiber Layer In Glaucoma Patients After Trabeculectomy

Objective:Glaucoma patients at different stages were selected and retinal nerve fiber layer(RNFL) thickness was determined before and after the trabeculectomy. We analyzed thefeatures of RNFL and compared the injury degree of optic nerve function in glaucomapatients.Methods:Fifty-eight patients in our hospital (23men and women35, average age54.5±10.5)were included in this prospectie study. According to the visual field, the patients weredivided into follow groups: the early group, the progressive group and the advancedgroup. We checked the patients in the vision, visual field, intraocular pressure and OCTat1day before operationa and1day,7days and1month after operation. The change ofRNFL thickness was analyzed and compared with normal control group.Results:1) Seventy-six cases complete the follow-up investigation, including18cases ofnormal control group. The number in the early group, the progressive group and theadvanced group was20,21and17, respectively. There were no significant difference ingender and mean age. Operation cannot improve the vision in the3groups.2) Mean visual defect of glaucoma patients had been significantly imprioved in theearly and progressive groups after1month of operation (P <0.05). However, there was no difference between preopreation and1month after operation in the advanced group,(P>0.05).3) The mean RNFL thickness is106.25±10.47microns in control group. At1daybefore operation and1day after operation, RNFL thickness was significantly higher inthe early group than in the control group (P <0.05); however, RNFL thickness wassignificantly lower at1month after operation (P <0.05). Compared with the controlgroup, RNFL thickness is significantly higher at1day after operation and significantlower at7days and1month after operation in the progressive group (P <0.05). On theother hand, At1day before operation, and1day,7days and1month after operation,RNFL thickness was significantly lower in the advanced group than in the control group(P <0.05).In general, RNFL thickness became low with the process of glaucoma.4) In the early group20cases,9cases vision completely normal, when in a stablecondition after1month, view of normal cases, RNFL thickness is lower than normalcontrol group (P <0.05).Conclusion:The visual field of glaucoma patients in the early group and the progressive groupwas improved after operation. In all stages of glaucoma groups, REFL layer became thinwith the condition of stability. Although the vision examination before operation had noabnormalities in the early group, RNFL layer become thin at1month after operation.Thus, RNFL is a sensitive index for the diagnosis of glaucoma optic nerve damage.