June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Prospective morphological subconjunctive analysis by spectral domain optical coherence tomography of blebless glaucoma surgeries
Author Affiliations & Notes
  • J. Aritz Urcola
    Ophthalmology, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
    Opthalmology, Begitek Clínica Oftalmológica, Donostia-San Sebastián, Spain
  • Cristian Dalmasso
    Ophthalmology, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
  • Javier Cabrerizo
    Ophthalmology, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
  • Amaia Latorre
    Research and development, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
  • Footnotes
    Commercial Relationships J. Aritz Urcola, None; Cristian Dalmasso, None; Javier Cabrerizo, None; Amaia Latorre, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4760. doi:https://doi.org/
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      J. Aritz Urcola, Cristian Dalmasso, Javier Cabrerizo, Amaia Latorre; Prospective morphological subconjunctive analysis by spectral domain optical coherence tomography of blebless glaucoma surgeries. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4760. doi: https://doi.org/.

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

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Abstract
 
Purpose
 

To provide by prospective spectral-domain anterior segment optical coherence tomography (AS-OCT) assessment, morphological details of blebless filtering glaucoma surgeries (nonpenetrating deep sclerectomy (NPDS) and combined phacoemulsification + NPDS) and analyze the correlation of intraocular pressure (IOP) reduction with any of the OCT parameters.

 
Methods
 

A total of 111 eyes were included in this study. All surgeries were performed with antimetabolite agent (mitomycin C 0.2 mg/ml) avoiding any scleral implant. 69 NPDS and 42 combined phacoemulsification + NPDS. IOP and morphological bleb features were prospectively analyzed by AS-OCT in 1 week, 1, 3, 6 and 12 months follow-up. Blebs were imaged with a commercially available AS-OCT system and the presence or absence of 3 qualitative parameters was analyzed: subconjunctival microcysts (SMC), posterior episcleral fluid (PEF) and anterior episcleral fluid (AEF).

 
Results
 

Postsurgical prospective analysis by AS-OCT of the bleb morphological features at each time point shows statistical differences in the frequency of these parameters. Presence of SMC, PFE decays progressively in first 6 months (from 82.7% and 85.3% in first week to 28.9% and 51.1% in 6 month follow-up respectively); whereas presence of AEF shows a converse evolution beyond the third month. It is present only in 4.8% of surgeries in first week and in 77.8% of cases in 6 month follow-up. Intraocular pressure and medication use reduction in all eyes were significantly decreased from baseline (IOP 23.8±7.4 mm Hg) at every time point (p<.001) with a mean IOP of 15.5±4.3 mm Hg in 12 month postoperative follow up. Nevertheless, greater IOP reduction levels were not statistically correlated with any of the 3 qualitative bleb parameters analyzed in each of the follow-up.

 
Conclusions
 

AS-OCT is a useful tool for the assessment of the filtering function in blebless glaucoma surgeries as NPDS and phacoemulsicication + NPDS. Morphological features of the filtering bleb changes dynamically in the first months of the glaucoma surgery and to monitor by new imaging techniques permits a comprehensive study of the ocular tissues responses to the wound healing process.

 
 
Subconjuctival microcyst present at first week postsurgery
 
Subconjuctival microcyst present at first week postsurgery
 
 
Fluid accumulation posterior to scleral flap edge present at first month postsurgery
 
Fluid accumulation posterior to scleral flap edge present at first month postsurgery
 
Keywords: 550 imaging/image analysis: clinical • 421 anterior segment • 765 wound healing  
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