Quantification of the filtering bleb's structure with anterior segment optical coherence tomography

Abstract

Early postoperative AS-OCT measurements of blebs, especially horizontal brightness of the bleb wall, were associated with postoperative IOP at 6 months. AS-OCT measurements of blebs may be useful predictors of trabeculectomy outcomes.

Optical coherence tomography analysis of filtering blebs after long-term, functioning trabeculectomy and XEN® stent implant

“…Conjunctival fibrosis has been associated with failure of filtration surgery and it is defined as the presence of areas with high reflectivity within the bleb, probably due to the high density of the connective tissue [9][10][11][12][13][14][15]. In the current study, we found areas of high reflectivity in 40% of TBs but not in the blebs that developed after implantation of the XEN Gel Stent®.…”

“…An earlier study of the blebs formed following XEN Gel Stent® implantation highlighted that in the majority of cases, their filtration characteristics suggested they functioned well [17], as found in all the XEN blebs studied here. However, only the internal reflectivity of the bleb was evaluated in this previous study, and quantitative parameters thought to be predictors of good aqueous humor drainage were not analyzed [8][9][10][11][12][13][14][15].…”

“…Our results using the IBAGS classification indicate that the blebs in trabeculectomy eyes were higher, broader, and with less vascularity than XEN eyes. It is clear that AS-OCT offers several advantages over slit lamp examination to accurately measure the bleb size or to evaluate the internal structures of the filtration blebs [9][10][11][12][13][14][15]. The filtering blebs obtained with the XEN Gel Stent® have previously been studied by AS-OCT [18], indicating that non-functioning blebs were flatter and with a higher bleb wall reflectivity.…”

“…Using AS-OCT, the height of the bleb, the bleb wall thickness, the reflectivity of the tissue, and the presence of epithelial microcysts can be assessed, all parameters related to the hypotensive efficacy of filtering surgeries [8][9][10][11][12][13][14][15].…”

Optical coherence tomography for examination of glaucoma surgery site

“…Утолщение и гипорефлективность стенки ФП, как правило, ассоциируются с успехом операции. При неудовлетворительном результате вмешательства визуализировались низкий профиль, плотная гиперрефлективная стенка подушки и адгезия конъюнктивы к склере или склерального лоскута к своему ложу -большинство авторов относят эти признаки к прогностически значимым [27,[47][48][49][50][51]. При этом с помощью ОКТ удавалось выявить причину ретенции -окклюзия фистулы, адгезия склерального лоскута либо склеро-конъюнктивальное сращение, блокада сгустками крови, пигментным листком радужки, смещение радужки гаптической частью интраокулярной линзы [52,53].…”