Characteristics of early filtering blebs that predict successful trabeculectomy identified via three-dimensional anterior segment optical coherence tomography

Akiko Narita, Yuki Morizane, Tomoe Miyake, Jiro Seguchi, Tetsuya Baba, Fumio Shiraga

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background/aims To identify the cross-sectional characteristics of filtering blebs at 2 weeks posttrabeculectomy associated with intraocular pressure (IOP) control at 1 year post-trabeculectomy. Methods Ninety-nine eyes of 94 patients who had undergone primary trabeculectomy were included in this retrospective consecutive case series study. Surgical success was defined as an IOP =15 mm Hg and a >20% reduction in IOP without glaucoma medication or additional glaucoma surgeries at 1 year post-trabeculectomy. Subjects were classified into two groups according to whether surgery was successful or unsuccessful. Blebs were examined using sweptsource three-dimensional anterior segment optical coherence tomography and evaluated for quantitative parameters, including maximum height, maximum wall thickness and ratio of hyporeflective space of the wall, as well as qualitative parameters, including multiple parallel hyporeflective layers within the wall (striping phenomenon), decreased visibility of the sclera underlying the bleb (shading phenomenon) and cyst-like structures of the wall. Results Seventy-seven eyes (77.8%) were assigned to the successful group and 22 (22.2%) to the unsuccessful group. Univariate analysis showed significant differences between the groups regarding maximum bleb height (p=0.044), maximum bleb wall thickness (p=0.017) and the striping phenomenon of the bleb wall (p=0.007). Multivariate logistic regression analysis confirmed that the striping phenomenon at 2 weeks posttrabeculectomy was significantly associated with success at 1 year post-trabeculectomy (OR 3.405; 95% CI 1.059 to 10.947; p=0.040). Conclusion Taller blebs with thicker walls that showed the striping phenomenon at 2 weeks posttrabeculectomy appeared to predict good IOP control at 1 year post-trabeculectomy.

Original languageEnglish
Pages (from-to)796-801
Number of pages6
JournalBritish Journal of Ophthalmology
Volume102
Issue number6
DOIs
Publication statusPublished - Jan 1 2018

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Trabeculectomy
Optical Coherence Tomography
Blister
Intraocular Pressure
Glaucoma
Sclera
Cysts
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Characteristics of early filtering blebs that predict successful trabeculectomy identified via three-dimensional anterior segment optical coherence tomography. / Narita, Akiko; Morizane, Yuki; Miyake, Tomoe; Seguchi, Jiro; Baba, Tetsuya; Shiraga, Fumio.

In: British Journal of Ophthalmology, Vol. 102, No. 6, 01.01.2018, p. 796-801.

Research output: Contribution to journalArticle

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abstract = "Background/aims To identify the cross-sectional characteristics of filtering blebs at 2 weeks posttrabeculectomy associated with intraocular pressure (IOP) control at 1 year post-trabeculectomy. Methods Ninety-nine eyes of 94 patients who had undergone primary trabeculectomy were included in this retrospective consecutive case series study. Surgical success was defined as an IOP =15 mm Hg and a >20{\%} reduction in IOP without glaucoma medication or additional glaucoma surgeries at 1 year post-trabeculectomy. Subjects were classified into two groups according to whether surgery was successful or unsuccessful. Blebs were examined using sweptsource three-dimensional anterior segment optical coherence tomography and evaluated for quantitative parameters, including maximum height, maximum wall thickness and ratio of hyporeflective space of the wall, as well as qualitative parameters, including multiple parallel hyporeflective layers within the wall (striping phenomenon), decreased visibility of the sclera underlying the bleb (shading phenomenon) and cyst-like structures of the wall. Results Seventy-seven eyes (77.8{\%}) were assigned to the successful group and 22 (22.2{\%}) to the unsuccessful group. Univariate analysis showed significant differences between the groups regarding maximum bleb height (p=0.044), maximum bleb wall thickness (p=0.017) and the striping phenomenon of the bleb wall (p=0.007). Multivariate logistic regression analysis confirmed that the striping phenomenon at 2 weeks posttrabeculectomy was significantly associated with success at 1 year post-trabeculectomy (OR 3.405; 95{\%} CI 1.059 to 10.947; p=0.040). Conclusion Taller blebs with thicker walls that showed the striping phenomenon at 2 weeks posttrabeculectomy appeared to predict good IOP control at 1 year post-trabeculectomy.",
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AB - Background/aims To identify the cross-sectional characteristics of filtering blebs at 2 weeks posttrabeculectomy associated with intraocular pressure (IOP) control at 1 year post-trabeculectomy. Methods Ninety-nine eyes of 94 patients who had undergone primary trabeculectomy were included in this retrospective consecutive case series study. Surgical success was defined as an IOP =15 mm Hg and a >20% reduction in IOP without glaucoma medication or additional glaucoma surgeries at 1 year post-trabeculectomy. Subjects were classified into two groups according to whether surgery was successful or unsuccessful. Blebs were examined using sweptsource three-dimensional anterior segment optical coherence tomography and evaluated for quantitative parameters, including maximum height, maximum wall thickness and ratio of hyporeflective space of the wall, as well as qualitative parameters, including multiple parallel hyporeflective layers within the wall (striping phenomenon), decreased visibility of the sclera underlying the bleb (shading phenomenon) and cyst-like structures of the wall. Results Seventy-seven eyes (77.8%) were assigned to the successful group and 22 (22.2%) to the unsuccessful group. Univariate analysis showed significant differences between the groups regarding maximum bleb height (p=0.044), maximum bleb wall thickness (p=0.017) and the striping phenomenon of the bleb wall (p=0.007). Multivariate logistic regression analysis confirmed that the striping phenomenon at 2 weeks posttrabeculectomy was significantly associated with success at 1 year post-trabeculectomy (OR 3.405; 95% CI 1.059 to 10.947; p=0.040). Conclusion Taller blebs with thicker walls that showed the striping phenomenon at 2 weeks posttrabeculectomy appeared to predict good IOP control at 1 year post-trabeculectomy.

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