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Claudia Thieme, Reinhard Burk; Anterior Segment Swept Source OCT for filtering bleb evaluation after Gel Stent implantation. Invest. Ophthalmol. Vis. Sci. 2020;61(7):946.
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© ARVO (1962-2015); The Authors (2016-present)
Successful filtration surgery depends on filtering bleb (FB) persistence. The aim of this study is to evaluate bleb morphology and persistence by anterior segment swept source OCT (ASOCT) after Gel-Stent-Implantation (XENTM).
ASOCT scans (Anterion ®, Heidelberg Engineering) of the FB were recorded in 19 eyes of 19 patients (9 female, 10 male; mean age 71.8 ±10 years; median MD 7.4dB, min. -3.4 max. 19.7; median sLV 6.5 dB min. 2.2 max.10.9) at T1: 238 days (±62 days) and T2: 520 days (±179 days) postoperatively. FB morphology was classified as microcystic (m), mixed (mx) or absent (a) according to the ASOCT scans. Correlations between FB classification, postoperative intraocular pressure (IOP) and medical therapy (TX) were analyzed with IBM SPSS Statistics Version 21.
FB classification at T1 was n=15 (class m), n=2 (class mx) and n=2 (class a). FB classification at T2 resulted in n= 12 (class m), n=1 (class mx) and n=6 (class a) (Figure 1). In the overall cohort (n=19) mean IOP reduction at T2 is significant (5.3mmHg±1.7mmHg, p=0.019), so is TX reduction (TX-mean difference 1.1±0.3, p=0.001). Prae op (pr) and post op (po) IOP readings in class “m” were 19.7±6.0 mmHg (pr) and 15.7±4.0 mmHg (po), 14 mmHg (pr) and 18 mmHg (po) in class “mx”, and in class “a” 23.8±6.7 mmHg (pr) and 16.5±4.6 mmHg (po). TXchange was from 2.9±1.3 to 1.3±1.5 in class “m”. From 1 to 2 in class “mx” and from 3.3±1.2 to 1.8 ±1.2 in class “a”.No significant differences in IOP reduction were found between FB classes “m”, “mx”, “a” (p=0.373)and TX (p=0.778).
In ASOCT scans, most filtering blebs after XEN Gel stent implantation have a microcystic appearance. Further studies are needed to evaluate long term bleb persistence.
This is a 2020 ARVO Annual Meeting abstract.
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