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Miriam Ramos-Hernandez, Miriam Ramos-Hernandez, Elia Chavez, Luz Giorgi-Sandoval, Jose Paczka; Clinical and Tomographic Findings in Filtering Blebs Undergoing Digital Compression. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4494.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate clinical and tomographic profile of filtering blebs of eyes requiring digital compression to decrease intraocular pressure (IOP) as compared to blebs spontaneously achieving adequate IOP
We prospectively assessed 13 eyes which underwent primary mitomycin C augmented trabeculectomy and required continuous digital compression (DC) to achieve target IOP; 18 additional operated eyes (equivalent type of filtering surgery) not requiring digital compression (NRDC) to reach adequate level of IOP were also included in the study. All cases underwent clinical photography and anterior segment tomography (Cirrus anterior segment module of optical coherence tomography; Carl Zeiss Meditec; San Leandro, California, U.S.A.). Filtering bleb photographs and tomographic images were assessed by the same investigator (JAP) in a masked fashion. Würzburg filtering bleb score was used for clinical assessment. A novel weighted score for tomographic analysis was also applied.
Thirteen eyes from 9 patients (mean age: 64.5 ± 8.2 years) belonging to the DC group had a mean IOP (13.4 ± 5.1 mm Hg) that was not significantly different to the mean value of IOP (14.1 ± 4.7 mm Hg, P > 0.05) of 18 eyes from 15 patients (mean age: 69.8 ± 4.9 years) of NRDC group. Mean scores derived from the Würzburg classification were not different between groups (8.5 ± 2.7. vs. 9.1 ± 3.2; DC vs. NRDC, respectively). In contrast, the tomographic score of the DC group (4.0 ± 2.6) was significantly different to the one obtained after scoring the NRDC group (7.6 ± 1.6, P = 0.01).
The current study suggests that structural findings of filtering blebs derived from anterior segment OCT (tomographic score) seems to perform better than clinical assessment to differentiate among blebs of different capacities of filtration.
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