Abstract
Purpose :
To analyse anterior segment optical coherence tomography (AS-OCT) imaging of the filtering bleb after trabeculectomy with amniotic membrane transplantation (AMT) and evaluate intrableb structural parameters associated with intraocular pressure (IOP) control.
Methods :
Ninety-six patients with primary open-angle glaucoma who underwent fornix-based trabeculectomy with AMT (AMT group; 85 eyes, 69 patients) or without AMT (control group; 31 eyes, 27 patients) were included. Intrableb structural parameters including bleb height, bleb wall thickness, striping layer thickness, bleb wall reflectivity, fluid-filled space area/height/score, and microcyst formation were evaluated on horizontal and vertical AS-OCT scans at least one year after trabeculectomy. Surgical success was defined as an IOP ≤ 18 mmHg and IOP reduction ≥ 20% without medication. Logistic regression analyses were performed to determine intrableb parameters associated with IOP control.
Results :
Patients with successful IOP control had greater bleb height, bleb wall and striping layer thickness, lower bleb wall reflectivity, and more frequent microcyst formation (all ps ≤ 0.023) in both groups. In the AMT group, the patients with successful IOP control had greater fluid-filled space area and score (all ps ≤ 0.043). Multivariate logistic regression analysis showed that lower bleb wall reflectivity alone was associated with successful IOP control in the control group [odds ratio (OR) = 0.812, p = 0.017]. Greater fluid-filled space score (OR = 8.016, p = 0.027), lower bleb wall reflectivity (OR = 0.913, p = 0.003), and microcyst formation (OR = 16.202, p = 0.041) were associated with successful IOP control in the AMT group.
Conclusions :
Hyporeflective bleb wall was associated with successful IOP control after trabeculectomy regardless of AMT. However, the extent of the fluid-filled space was associated with successful IOP control only after trabeculectomy with AMT.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.