June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Evaluation of filtration blebs by anterior segment optical coherence tomography (AS-OCT) after conventional trabeculectomy and trabeculectomy with antifibrotic agents
Author Affiliations & Notes
  • Yael Azses
    Asociación para evitar la ceguera en México, Mexico City, Mexico
  • Cindy Anahi Haro Zuno
    Asociación para evitar la ceguera en México, Mexico City, Mexico
  • Jesus Jimenez Arroyo
    Asociación para evitar la ceguera en México, Mexico City, Mexico
  • Magdalena Garcia Huerta
    Asociación para evitar la ceguera en México, Mexico City, Mexico
  • Mauricio Turati Acosta
    Asociación para evitar la ceguera en México, Mexico City, Mexico
  • Felix Gil Carrasco
    Asociación para evitar la ceguera en México, Mexico City, Mexico
  • Jesus Jimenez-Roman
    Asociación para evitar la ceguera en México, Mexico City, Mexico
  • Footnotes
    Commercial Relationships   Yael Azses, None; Cindy Anahi Haro Zuno, None; Jesus Jimenez Arroyo, None; Magdalena Garcia Huerta, None; Mauricio Turati Acosta, None; Felix Gil Carrasco, None; Jesus Jimenez-Roman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2091. doi:
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      Yael Azses, Cindy Anahi Haro Zuno, Jesus Jimenez Arroyo, Magdalena Garcia Huerta, Mauricio Turati Acosta, Felix Gil Carrasco, Jesus Jimenez-Roman; Evaluation of filtration blebs by anterior segment optical coherence tomography (AS-OCT) after conventional trabeculectomy and trabeculectomy with antifibrotic agents. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2091.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Evaluate the anatomic characteristics of filtering blebs in patients with conventional trabeculectomy (TBC) vs trabeculectomy with Mitomycin C (TBC+MM) and Collagen-polyvinylpyrrolidone (TBC+CP) using AS-OCT. We measured the wall thickness, presence of microcysts, and cavities, in order to find clinical correlation between the anatomy of the bleb, the intraocular pressure (IOP) and the amount of drugs used before and after surgery

Methods : Cross-sectional, observational and descriptive study. We included patients with TBC, TBC+MM and TBC+CP. We measured the IOP and amount of antihypertensive drugs before, and one year after surgery, with a subsequent complete ophthalmologic evaluation emphasized in anatomical features of the bleb. AS-OCT was performed for morphological evaluation.

Results : 25 eyes were included; 36% in the TBC+MMC group, 32%TBC+CP, and 32%TBC. The average age was 64.36 years (SD 16.7). A reduction of 11.1mmHg IOP was observed in TBC+MMC, TBC+CP 9.88mmHg, and TBC 7.13mmHg, which was clinically relevant but not statistically significant (p =0.220). A reduction of antihypertensive drugs in TBC+MMC was 2.8, TBC+CP 2.1, and 0.8 TBC, being statistically significant (p=0.002). In anatomical assessment of the filtration bleb, the wall thickness average of the bleb in TBC+MMC was 51 microns, TBC+CP of 57 and TBC 83. There was statistical difference between the TBC+MMC vs TBC (p=0.001), and in the TBC+CP vs TBC (p=0.021). No significant statistical difference was found between TBC+MMC vs TBC+CP (p=0.806). In TBC+MMC we found moderate microcysts in 33.3%, abundant in 66.7% and cavities (subconjunctival lagoons) in 67.7%, no fibrosis observed. In TBC+CP moderate microcysts 75% and 25% abundant, formation of cavities in 34%, no fibrosis was found. In TBC few microcysts in 37.5%, moderate in 37.5% and 25% abundant, subconjunctival fibrosis in 37.5%

Conclusions : The use of MMC and CP improves the function of the filtration bleb, achieving surgical success. It was observed that the reduction of IOP in patients that use antifibrotics was clinically but not statistically significant, compared with the conventional TBC. However, there was a significant statistical relevance regarding the reduction of ocular hypotensive drugs used after surgery, which correlates with the anatomical findings of the bleb

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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