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K. Kawana, S. Fukuda, M. Sato, T. Kiuchi, Y. Yasuno, T. Oshika; Evaluation of Trabeculectomy Bleb Using Three Dimensional Cornea and Anterior Segment Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5074.
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To evaluate relationships between trabeculectomy bleb formation and intraocular pressure (IOP) using three-dimensional cornea and anterior segment optical coherence tomography (3D CAS-OCT).
A total of 36 eyes from 31 patients who had had trabeculectomy were evaluated using 3D CAS-OCT. The mean age of the participants was 58.3 ± 14.5 years old (mean ± standard deviation). The mean IOP was 12.0 ± 5.1 mmHg at the time of measurement. The three dimensional CAS-OCT prototype was built by the Computational Optics Group at the University of Tsukuba and Tomey Corporation (Nagoya, Japan). Using 1.3 um light source, the CAS-OCT can create 3D images of the anterior segment including internal bleb and angle recess in 3 seconds. The measurement parameters of the bleb were horizontal and vertical fluid filled length and height, internal fluid volume, wall thickness (minimum and maximum), and total height. The participants were classified into low IOP and high IOP groups. The low IOP group was defined as eyes whose IOP was below 18 mmHg without topical glaucoma medication.
There were significant correlations between IOP and horizontal longitudinal length (r = -0.59, P < 0.0002, Pearson correlation coefficient), internal fluid volume (r = -0.38, P = 0.027), bleb maximum thickness (r = -0.35, p = 0.039), and bleb height (r = -0.35, P = 0.040). Twenty-five blebs (69%) were classified as low IOP. There were significant differences in horizontal longitudinal length (P = 0.0036, unpaired t-test), vertical longitudinal length (P = 0.045), internal fluid volume (P = 0.011), bleb maximum thickness (P = 0.0084), and total height (P = 0.009) between low and high IOP groups.
Three-dimensional CAS-OCT revealed internal bleb structures. Large internal fluid filled space and thick bleb wall contributed to lower postoperative IOP.
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