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Lukas Pfenninger, Fabienne Schneider, Jens Funk; Internal Reflectivity of Filtering Blebs versus Intraocular Pressure in Patients with Recent Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2011;52(5):2450-2455. doi: 10.1167/iovs.10-5520.
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The authors conducted a morphology analysis of filtering blebs with anterior segment optical coherence tomography (AS-OCT) in patients shortly after trabeculectomy to find further criteria for success or failure of a filtering bleb.
Thirty-seven patients (43 eyes) who had recently (<2 years) undergone trabeculectomy were measured 1 to 4 times with AS-OCT. In contrast to ultrasound biomicroscopy, AS-OCT eliminates the need for a water bath in contact with the globe. This is of particular value in a study of morphologic parameters that may be altered by contact and in the postoperative period when concerns of infection are paramount. In this study, the internal reflectivity of the fluid-filled cavity of the filtering bleb was compared with the intraocular pressure (IOP).
Mean age of the patients was 69.5 years (range, 27–84 years). Average preoperative IOP of the 43 eyes was 20.6 mm Hg (range, 10–42 mm Hg), average postoperative IOP at the time of AS-OCT measurement was 10.6 mm Hg (range, 2–40 mm Hg), and mean IOP reduction was 10.0 mm Hg (48.5%). Internal reflectivity of the fluid-filled cavity of the filtering bleb correlated very well to the IOP (R 2 = 0.3762, n = 61, P < 0.0001).
AS-OCT is a promising tool with which to analyze the morphology of the filtering bleb after trabeculectomy. A highly significant correlation between the internal reflectivity of the fluid-filled cavity of the filtering bleb and the IOP could be shown that may have future impact in evaluating the postoperative success or failure of filtering blebs.
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