Lamina Cribrosa Reversal after Trabeculectomy and the Rate of Progressive Retinal Nerve Fiber Layer Thinning

Association of Corneal Hysteresis With Lamina Cribrosa Curvature in Primary Open Angle Glaucoma

“…In addition, re-elevation of IOP, due to a decrease in bleb function, in patients who underwent trabeculectomy resulted in the posterior movement of anteriorly-shifted LC. 8,10 These findings suggest that IOP-related stress is a key driving force that induces and maintains posterior LC bowing. However, the degree of posterior LC deformation is not simply dependent on IOP level but is influenced by other factors, including the material properties of the LC.…”

“…5 Studies have shown that LC position and curvature change in accordance with changes in IOP. Reduction in IOP, either through surgery [6][7][8] or medication, 9 was shown to result in anterior shift of the LC position and flattening of the LC curve. In addition, re-elevation of IOP, due to a decrease in bleb function, in patients who underwent trabeculectomy resulted in the posterior movement of anteriorly-shifted LC.…”

Peripapillary Microvascular Improvement and Lamina Cribrosa Depth Reduction After Trabeculectomy in Primary Open-Angle Glaucoma

“…Recent studies have reported that position of the lamina cribrosa (LC) can be changed after surgical lowering of IOP, and that the reversal of LC displacement is related to a slower rate of disease progression. 6,7 The effect of IOP-related stress on the LC may induce occlusion of the laminar capillaries and axonal ischemia 8 ; therefore, it is believed that the change of LC position would provide relief to compressed capillaries in the LC. 6 Ocular hemodynamic alteration after surgical IOP lowering has been demonstrated in previous studies, [9][10][11][12][13] most of which reported an increase in ocular blood flow parameters in patients with glaucoma after a significant drop in IOP after trabeculectomy.…”

Lamina cribrosa in glaucoma

“…LC depth was reduced significantly at both follow up visits, which indicates that LC cupping was reversed after IOP lowering, and that reversal was largely sustained over time. The rate of postoperative RNFL thinning was significantly slower in those patients in whom IOP did not rise and LC depth retained its more anterior post-surgical position at the 2.5 year follow up visit [43]. Another longitudinal study showed that the rate of RNFL thinning was significantly associated with greater LC depth measured at presentation in a cohort of 110 Korean glaucoma patients [44].…”