July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Factors related to filtration-bleb morphology after Ex-PRESS surgery
Author Affiliations & Notes
  • Naoki Tojo
    University of Toyama, Toyama City, Japan
  • Mitsuya Otsuka
    University of Toyama, Toyama City, Japan
  • Atsushi Hayashi
    University of Toyama, Toyama City, Japan
  • Footnotes
    Commercial Relationships   Naoki Tojo, None; Mitsuya Otsuka, None; Atsushi Hayashi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3731. doi:
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      Naoki Tojo, Mitsuya Otsuka, Atsushi Hayashi; Factors related to filtration-bleb morphology after Ex-PRESS surgery. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3731.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Purpose: We investigated the factors influencing the morphology of filtration blebs after Ex-PRESS surgery. We analyzed the thickness of the bleb wall and the height and the volume of blebs.

Methods : Methods: This was a retrospective non-randomized study. After excluding patients who had undergone an additional glaucoma surgery, 145 glaucoma patients who underwent Ex-PRESS surgeries and were followed up for >1 year were analyzed. We used anterior segment optical coherence tomography to analyze the morphology of the blebs after Ex-PRESS surgery. We also examined potential influencing factors including age, central corneal thickness (CCT), type of glaucoma (primary open angle glaucoma [POAG] or pseudo-exfoliation glaucoma [PEXG]), preoperative intraocular pressure (IOP), postoperative IOP, history of trabeculotomy, and operation method: Ex-PRESS surgery only, or simultaneous cataract surgery.

Results : Results: Ex-PRESS surgeries significantly decreased the IOP from 24.5 ± 8.8 mmHg to 11 ± 3.4 mmHg after 1 year (p<0.001). The cases with higher blebs, larger volume of blebs, and thinner bleb wall had better surgical outcomes.

Conclusions : Conclusions: Advanced age, higher postoperative IOP, PEXG, and simultaneous cataract surgeries were found to decrease the volume and height of blebs. Younger age, higher postoperative IOP, POAG and simultaneous cataract surgeries were found to thicken the wall of blebs. Among the younger patients, there were many cases in which surgery was unsuccessful despite the large volume of blebs. The reason for this may be that the wall of the bleb is thick.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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