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Abstract Surgical IOP lowering in cases of Primary open-angle glaucoma has been shown to cause changes in ocular haemodynamics. Previous techniques to assess ocular vasculature had various limitations. Invention of Optical Coherence Tomography Angiography enabled clinicians to assess ocular microvasculature without injection of contrast dye into the human body. It produces high resolution images of retinal microvasculature. This study was carried out at Mansoura ophthalmic center during the period from February 2018, till august 2019, to detect macular vessel density changes before and after trabeculotomy operation in cases of primary open angle glaucoma using swept source optical coherence tomography angiography (OCTA). The study included 28 eyes of 27 patients with primary open angle glaucoma. This study revealed the following results: 1. We found out that there was a significant post operative reduction in mean IOP after trabeculotomy operation from (26.55 ± 7.279) to (13.20 ± 4.69) at three months postoperatively. 2. There was a transient reduction in best corrected visual acuity early postoperatively, which then improved again after one month postoperatively. The mean BCVA was (0.52 ± 0.40) preoperatively and (0.47 ± 0.40) at three months postoperatively. 3. There were no significant changes between preoperative and postoperative cup-disc ratio. 4. There was significant improvement in VD in the foveal, superior and inferior macular zones. |