Abstract
Abstract: :
Purpose:To describe the features of the filtering bleb in trabeculectomy, by high–resolution optical coherence tomography of the third generation (StratusOCT, OCT–3) and to correlate the function of the filtering bleb with the StratusOCT images. Methods: Filtering bleb configuration of 33 patients with medically uncontrolled primary open angle glaucoma, submitted to trabeculectomy without adjunctive antimetabolites, was studied using StratusOCT. Morphology and reflectivity of the bleb were the parameters evaluated and compared with the histologic standard features of a filtering bleb. The presence of the aqueous route under the scleral flap was correlated with the IOP control. Results: Functioning blebs, defined as having an IOP of < 21 with or without medications, showed low reflectivity within the bleb cavity, multiple hypo–reflective microcystic spaces, and a clearly visible route underneath the scleral flap. In failed blebs, defined as those with IOP > 21 despite medications, OCT showed disorganized fibrous tissue without microcysts and no visible space beneath the scleral flap. Conclusions: StratusOCT represents a fast and non invasive method capable to detect and analyze in vivo the structures inside the filtering bleb after trabeculectomy and to significantly correlate the bleb function with the morphologic OCT image.
Keywords: intraocular pressure • trabecular meshwork • wound healing