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M. Singh, P. T. K. Chew, J. L. See, C. Zheng, T. Aung; Longitudinal Quantitative Analysis of Bleb Morphology Using Anterior Segment Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5075. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To quantitatively analyze bleb morphology using anterior segment optical coherence tomography (ASOCT).
This was a prospective observational study of patients who underwent standardized fornix-based trabeculectomy surgery with mitomycin-C and completed 6 months follow-up. Blebs were imaged in a standardized manner with the ASOCT prototype (Carl Zeiss Meditec Inc, Dublin, CA, USA) at 1 day, 1 week, 1 month, 3 months and 6 months after trabeculectomy. Customized software was used to obtain measurements of maximal bleb height h, total bleb cross-sectional area At, bleb wall cross-sectional area Aw, maximal bleb cavity height c and bleb cavity cross-sectional area Ac within 7mm from the limbus (Fig. A and B). Success was defined as intraocular pressure ≤ 18 mmHg without ocular hypotensive medication at 6 months.
Thirty-five eyes of 35 patients were included. There were 23 (65.7%) men and the mean age of patients was 65.1 ± 7.8 years. Six months postoperatively, successful blebs had greater total bleb cross sectional area At compared to failed blebs (7.27 ± 2.33 vs. 3.90 ± 1.23 mm2, p=0.02). There was no significant difference in bleb height h (1.64 ± 0.60 vs. 1.12 ± 0.61 mm, p=0.16), bleb wall cross-sectional area Aw (4.16 ± 0.91 vs. 3.44 ± 0.42 mm2, p=0.19), maximal bleb cavity height c (0.94 ± 0.64 vs. 0.24 ± 0.34 mm, p=0.07) or bleb cavity cross-sectional area Ac (2.78 ± 2.32 vs. 0.45 ± 0.64 mm2, p=0.1) between successful and failed blebs.
In this prospective longitudinal follow-up of blebs after trabeculectomy with mitomycin-C, bleb morphology can be quantified using ASOCT.
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