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Elena Milla, Javier Zarranz-Ventura; Evaluation of glaucoma filtering blebs with a swept-source Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2722.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the potential of a posterior-segment swept-source Optical Coherence Tomography (SS-OCT) device (DRI-OCT-1 Atlantis, Topcon, Japan) to analyze the status of filtering blebs after a variety of glaucoma surgical procedures
Observational, exploratory, single-center cohort study. 22 eyes (22 patients) that underwent glaucoma surgery in a single unit were included in the study. Postoperative visits were performed at 1 day, 1 week and 1 month after surgery as per routine standard care, and direct SS-OCT images of the filtering bleb were captured at these timepoints for comparison purposes. Clinical examination findings were correlated with SS-OCT-derived image findings.
Surgical procedures performed were deep non-penetrating sclerectomy (63.6%, 14/22), trabeculectomy (4.5%, 1/22), Express implant (27.7%, 6/22) and bleb revision (4.5%, 1/22). Direct SS-OCT images were captured at 1 day postop in 88.2% (15/17), at 1 week postop in 85.7% (6/7), and 1 month postop in 100% (3/3) of the cases. In all SS-OCT image sets (100%) it was possible to identify either 1) aqueous, seen as an hyporreflective layer surrounding the scleral flap, 2) subtenonian implants, and/or 3) scleral flap edges with no subtenonian fluid in failed surgical procedures.
This exploratory study supports the hypothesis that it is possible to identify aqueous and subtenonian implants in filtering blebs after surgery using a posterior-segment SS-OCT device. The identification of these structures may provide accurate information of postoperative status of filtering blebs, and may help to identify surgical failures and potentially predict surgical outcomes. These findings suggest that SS-OCT derived findings may be employed in future clinical trials as an objective, quantitative endpoint of surgical success in glaucoma surgery.
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