Anterior Chamber Morphometrics Before and After Sutureless Trabeculectomy in Primary Open-angle Glaucoma: A Prospective Cohort Assessed by AS-OCT

Background: Enhancement of the anterior chamber angle morphometric parameters following surgery is essential in patients with primary open-angle glaucoma (POAG). This study aimed to compare the morphometric changes of the anterior chambers in POAG patients before and after sutureless trabeculectomy surgery with the anterior segment-optical coherence tomography (AS-OCT) device. Methods: In the present longitudinal study, 52 POAG patients with moderate or severe glaucomatous damage were diagnosed by an experienced ophthalmologist in the population referred to Al-Zahra Ophthalmology Hospital, Zahedan City, in 2023. Using the Casia AS-OCT, anterior segment biometric measurements were performed on each subject. Information was collected at baseline, immediately after, and 1 and 3 months later. Repeated measures ANOVA was employed for the change comparisons. Data were analyzed using SPSS version 25, and statistical significance was determined at a threshold of P < 0.05. Results: The mean age of all participants was 45.3 ± 4.1 years, and 62% (n = 32) were male. Our results indicated a reduction in all features, except for anterior chamber depth (ACD), at 1 and 3 months after trabeculectomy compared with both the baseline and the immediate postoperative measurements. The findings were statistically significant over time (P < 0.05) except for ACD (P = 0.34). Conclusion: The most crucial component of surgical therapy for POAG long-term outcomes is trabeculectomy. Given the significant impact of trabeculectomy on the anterior chamber angle, AS-OCT represents a reliable and effective modality for assessing the angle both preoperatively and postoperatively.