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Takahiro Kawaji, Toshihiro Inoue, Riyo Matsumura, Utako Kuroda, Nakashima Kei-Ichi, Hidenobu Tanihara; Trabeculectomy bleb assessment via three-dimensional anterior segment optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2262.
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To evaluate the morphological features of filtering blebs after trabeculectomy by using three-dimensional anterior segment optical coherence tomography (3D AS-OCT).
This retrospective cross-sectional study evaluated 73 patients who had undergone trabeculectomy with mitomycin C. All blebs were imaged with 3D AS-OCT and analyzed with our custom software. We assessed blebs quantitatively for the following features: bleb height, fluid-filled cavity height, bleb wall thickness, and bleb wall intensity.
The mean (± standard deviation [SD]) time period between trabeculectomy and 3D AS-OCT measurement was 22.7 ± 25.5 months; the mean (±SD) intraocular pressure (IOP) measured 13.8 ± 3.9 mm Hg at the time of 3D AS-OCT imaging. IOP and the bleb height (rs = -0.389, P = .0007) and IOP and the bleb wall intensity (rs = 0.399, P = .0005) showed statistically significant correlations. Eyes with limbus-based conjunctival flaps had a higher bleb height (P = .01), an increased fluid-filled cavity height (P = .0003), and a lower bleb wall intensity (P = .02) compared with eyes with fornix-based flaps. Bleb wall thickness in these 2 groups did not differ significantly (P = .17).
Our 3D AS-OCT imaging, which can evaluate morphological features of trabeculectomy blebs quantitatively and noninvasively, showed that the bleb height and intensity of the bleb wall had significant relationships to the IOP. Limbus-based procedures produced higher blebs, increased fluid-filled cavities, and lower intensity of the bleb wall.
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