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D. Bellicaud, J.-M. Gregoire, F. Tranquart, P.-J. Pisella; Utility of a 20mhz Ultrasound Biomicroscopy Exam in the Follow-Up of Filtering Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3368.
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Decisional help brought by a 20MHz ultrasound biomicroscopy (UBM) in the follow-up of filtering surgery.
Use of a 20MHz UBM developed by ATYS Médical®. Eighty two glaucomatous patients with previous filtering surgery (trabeculectomy or nonpenetrating deep sclerectomy, between February 2004 and February 2007) were enrolled in this retrospective study. The imagery was carried out independently (DB) compared to the clinical follow-up (PJP). The patients were classified in three groups according to their post-operative intraocular pressure (1: ≤ 20mmHg without treatment, 2: ≤ 20mmHg with treatment, 3: > 20mmHg in spite of a treatment). A morphological analysis of the filtering blebs was carried out for each of the three groups (route of filtration, scleral flap, under-conjunctival space).
93 filtering blebs of 67 patients were analyzed. The median time between the surgery and echography was 14 ± 8,9 months. A low-reflective under-conjunctival space, a visible scleral flap and a visible route of filtration were the morphological aspect associated with a functional bleb (groupe1). An isoechoic under-conjunctival space, a visible scleral flap and an absence of the route of filtration characterize groups 2 and 3. Flat blebs were representative of non functional bleb whereas blebs containing microcysts were representative of functional bleb. There was no clinical or morphological differences (excepted the trabeculodescemetic membrane) between both types of surgery.
In the follow-up of filtering surgery, 20MHz UBM exam could be, as a simple and non-invasive imaging technique, use for giving a decisional help, complementary to the clinical follow-up.
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