Asima Rafique, Asad Aslam Khan, Muhammad Shaheer.
Changes in Retinal Nerve Fiber Layer Thickness on Heidelberg Retinal Tomography in patients of Primary Open Angle Glaucoma After Trabeculectomy Versus Anti Glaucoma Medication.
Khyber Med Uni Med J Jan ;12(3):211-5.

OBJECTIVE: To compare the retinal nerve fiber layer (RNFL) thickness changes in patients of primary open-angle glaucoma after trabeculectomy versus anti-glaucoma medication. METHODS: This quasi-experimental study was conducted from 10th February, 2017 to 28th February, 2018 on 60 patients presenting to the Institute of Ophthalmology, Mayo Hospital, Lahore, Pakistan using non-probability consecutive sampling. Patients were assigned to two equal groups: group A (n=30) patients underwent trabeculectomy while group B (n=30) patients were put on anti-glaucoma medication. Pre-treatment and three months post-treatment RNFL thickness was recorded and then analyzed using SPPSv.18.0. RESULTS: Out of 60 patients, Group A (n=30) had 14 (46.71%) males and 16 (53.31%) females, while Group B (n=30) had 16 (53.31%) males and 14 (46.71%) females. The mean age was 55.901 +- 4.221 and 55.431 +- 3.971 years in Group A and Group B respectively (p=0.661). In age group, 16 (53.31%) each in Group A and Group B were <55 years. Hypertensive status showed 9 (30.01%) and 5 (16.71%) hypertensive patients in Group A and Group B respectively. Mean change in RNFL thickness was 0.028 +- 0.012u and 0.013 +- 0.007u in Group A and Group B respectively (p=<0.001). Pre and post-treatment (pre:post) RNFL thickness (u) in males, females, hypertensive, non-hypertensive, age <55 years, and age >=55 years was 0.201 +- 0.175u:0.226 +- 0.155, 0.205 +- 0.159:0.233 +- 0.019, 0.193 +- 0.015:0.223 +- 0.013, 0.206 +- 0.015:0.233 +- 0.018, 0.208 +- 0.015:0.232 +- 0.021, and 0.196 +- 0.016:0.228 +- 0.015 for Group A and 0.211 +- 0.018:0.224 +- 0.019, 0.201 +- 0.015:0.215 +- 0.014, 0.214 +- 0.015:0.226 +- 0.016, 0.205 +- 0.018:0.218 +- 0.017, 0.206 +- 0.017:0.219 +- 0.015, and 0.209 +- 0.019:0.221 +- 0.020 for group B respectively. CONCLUSION: Trabeculectomy increases thickness of retinal nerve fiber layer more than anti glaucoma medication.

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