Anterior Chamber Angle Changes and Surgical Outcomes After Combined Phacoemulsification and High-Frequency Deep Sclerotomy: A Prospective AS-OCT Study
Journal of Glaucoma, cilt.Publish Ahead of Print, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: Publish Ahead of Print
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/ijg.0000000000002704
- Dergi Adı: Journal of Glaucoma
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: anterior segment OCT, high-frequency deep sclerotomy, intraocular pressure, minimally invasive glaucoma surgery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Précis: – Postoperative AS-OCT evaluation after combined phacoemulsification and HFDS revealed specific AS-OCT angle parameters correlated with surgical success, supporting its role as a potential imaging biomarker for long-term glaucoma surgery follow-up. Purpose: – To evaluate postoperative anterior-segment optical coherence tomography (AS-OCT) parameters following combined high-frequency deep sclerotomy (HFDS) and phacoemulsification surgery and to assess their relationship with intraocular pressure (IOP) reduction and medication use over an 18-month period. Methods: – This prospective observational study included 75 eyes of patients with primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEX) who underwent combined phacoemulsification and HFDS. AS-OCT imaging was performed between 1 and 18 months postoperatively to measure angle opening distance (AOD500/750), trabecular-iris space area (TISA500/750), and scleroconjunctival complex thickness (SCT). The presence of episcleral hyporeflective spaces (EHS) was also recorded. Surgical success was defined as complete (IOP ≤21 mmHg, ≥20% reduction, without medication) or qualified (with medication). Results: – Mean IOP decreased significantly from 16.8±4.0 mmHg to 14.2±2.9 mmHg at 18 months, with a marked reduction in medication use. Complete success was achieved in 65.3% of eyes. Postoperative AS-OCT showed generalized widening of anterior chamber angles. Measurements at 500 µm were not associated with IOP outcomes, whereas some 750-µm parameters—particularly nasal AOD750—showed variable associations with IOP reduction depending on outcome definitions and pressure change magnitude. SCT and EHS didn’t differ between outcome groups. No significant differences were found between POAG and PEX eyes, and AS-OCT parameters remained stable throughout follow-up. Conclusions: – Combined phacoemulsification and HFDS provide sustained IOP reduction and medication decrease over 18 months. AS-OCT shows postoperative angle widening and suggests that 750-µm posterior angle measurements may reflect surgical outcomes.