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Toshihiro Inoue, Sachi Kojima, Ayako Fukushima, Nakashima Kei-Ichi, Hidenobu Tanihara; Prospective investigation of filtering bleb by three-dimensional anterior-segment optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):944.
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To evaluate the time-dependent changes of the filtering bleb using three-dimensional anterior-segment optical coherence tomography (3D AS-OCT).
In this prospective study, we investigated the postoperative intraocular pressure (IOP) and bleb parameters including total bleb height, fluid-filled cavity height, bleb wall thickness, bleb wall intensity, and location of the filtration opening on the scleral flap 0.5, 3, 6 and 12 months after fornix-based trabeculectomy with the aid of 3D AS-OCT and custom software. Patients with neovascular glaucoma, trabeculectomy combined with other ocular surgeries and a history of ocular surgeries except phacoemulsification were excluded.
Thirty-nine patients were enrolled and 30 patients completed 1-year investigations and were analyzed. Among the bleb parameters, IOP (P = 0.001), the number of eye drops (P = 0.045), and the distance from the top of the scleral flap to the filtration opening (P = 0.001) were significantly higher and the width of the filtration opening (P = 0.001) was significantly lower at 12 months than at 0.5 months after trabeculectomy. The fornix-side edge of the filtration opening shifted towards limbus (P = 0.006), while the limbal-side edge of it did not present significant shift between 0.5 and 12 months after trabeculectomy. Moreover, the width of the filtration opening at 0.5 months was significantly correlated with the IOP at 3 months (P = 0.004).
The location of the filtration opening on the scleral flap of the filtering bleb was firstly reported to change in a time-dependent manner after trabeculectomy. The width of the filtration opening at 2 weeks after trabeculectomy may be a prognostic factor of IOP at 3 months.
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