# Microvasculature recovery in lamina cribrosa and peripapillary sclera after glaucoma surgery and its impact on visual field progression

## TL;DR

This study shows that recovery of blood vessels in specific eye regions after glaucoma surgery is linked to slower vision loss.

## Contribution

The study identifies distinct anatomical and demographic factors influencing microvasculature recovery in lamina cribrosa and peripapillary sclera after glaucoma surgery.

## Key findings

- Laminar vessel density recovery was associated with shorter axial length and thinner corneal thickness.
- Peripapillary scleral vessel density recovery was linked to younger age and longer axial length.
- Both types of vessel density recovery significantly reduced the risk of visual field progression.

## Abstract

This study investigates vessel density (VD) changes in the lamina cribrosa (LC) and peripapillary sclera (PPS) after glaucoma surgery and their association with visual field (VF) progression. Primary open-angle glaucoma patients undergoing surgery for uncontrolled intraocular pressure (IOP) at Seoul St. Mary’s Hospital were included. Optical coherence tomography angiography (OCT-A) assessed VD changes in the LC and PPS one month post-surgery. VF progression was evaluated using mean deviation (MD) values from serial VF tests over six months. Of 80 enrolled eyes, 74 were analyzed. Laminar VD recovery occurred in 12 eyes (16.2%), with a 21.92% ± 7.37% increase, linked to shorter axial length (P = 0.005), thinner corneal thickness (P = 0.016), and less PPS VD change (P < 0.001). PPS VD recovery occurred in 14 eyes (18.9%), with an 18.50% ± 7.28% increase, associated with younger age (P = 0.043), longer axial length (P = 0.010), and lower preoperative PPS VD (P < 0.001). Multivariate analysis showed that both laminar and PPS VD recovery significantly reduced VF progression risk (P < 0.001). VD recovery, particularly in the LC, predicts better glaucoma outcomes. The distinct responses of LC and PPS to IOP reduction highlight the need to consider individual anatomical factors in glaucoma management.