Abstract
Purpose :
The outcome of 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).
Methods :
ASOCT scans (Anterion ®, OCT II, Heidelberg Engineering) of the FB were recorded in 44 eyes of 44 glaucoma patients (30 primary open-angle-glaucoma (pOAG), 11 secondary open-angle glaucoma with pseudoexfoliation (sOAG with PEX) and 3 with pigmentdispersion; 17 female, 27 male; mean age 71 ±12 years; visual field Median MD 10.3; Median sLV 6.4) at 97 days (±52 days, T1) and 690 days (±242 days, T2) 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.
Results :
AT T1, FB classification was n=39 (m), n=1 (mx) and n=4 (a). FB classification at T2 resulted in n= 19 (m), n=14 (mx) and n=11 (a). IOD reduction was significant (T0 to T1: mean 6.8±1.3, p=0.000; T0 to T2: mean 7.6±1.9, p=0.000). MED reduction was significant (T0 to T1: mean 2.4±0.2, p=0.000; T0 to T2: mean 2.8±0.5, p=0.000). Bleb classification remained stable in n=18. A change of bleb classification between T1 und T2 occured in 26 eyes : m to mx (n=13); m to a (n=9); mx to a (n=1); a to m (n=2) and a to mx (n=1).The revision rate at 180 days was 55.6% and at 365 days 72.2%.
Conclusions :
By ASOCT scans, most filtering blebs after XEN Gel stent implantation have a microcystic appearance in the short postoperative period. However, bleb appearance may change in the follow up period. Further studies are needed to evaluate long term bleb persistence.
This is a 2021 ARVO Annual Meeting abstract.