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K. Kawana, T. Kiuchi, Y. Yasuno, T. Oshika; Comparison of Limbus- and Fornix-Based Trabeculectomy Blebs Using Three Dimensional Cornea and Anterior Segment Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2009;50(13):176.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate blebs after limbus- and fornix- based trabeculectomy using three dimensional cornea and anterior segment optical coherence tomography (OCT, CASIA prototype, Tomey).
A total of 31 eyes from 31 patients (61.5 ± 11.0 years old) (mean ± standard deviation) who had undergone trabeculectomy were evaluated using CASIA prototype 3 months after surgery. Limbus- and fornix-based trabeculectomy was performed on 15 and 16 eyes, respectively. Intraocular pressure (IOP) was 10.7 ± 4.3 mmHg at the time of evaluation. Using a 1.3 um light source and swept-source OCT technology, CASIA can create three-dimensional images of the anterior segment, including internal bleb structure, in 0.3 to 2.2 seconds. The parameters evaluated about the blebs were volume of the internal fluid-filled cavity, volume of reticulated area, wall thickness (minimum and maximum), total height, number of microcysts, and visibility of scleral flap.
The rate of eyes with more than 10 microcysts was significantly higher in limbus-based blebs than in fornix-based blebs (P = 0.039, chi-square test). Eyes with limbus-based blebs showed significantly greater data variance in postoperative IOP, volume of the internal fluid-filled cavity, volume of reticulated area, wall thickness (minimum and maximum), and total bleb height (P < 0.05, t-test, Welch’s t-test). There was no significant difference in the visibility of scleral flap between two groups (P = 0.25, chi-square test).
More microcysts were found in limbus-based blebs than in fornix based blebs. There were no significant differences in intra-bleb structures between the two groups, but greater data variations were seen in limbus-based blebs.
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