Early bleb parameters as long-term prognostic factors for surgical success: a retrospective observational study using three-dimensional anterior-segment optical coherence tomography.

Abstract

BACKGROUND:

The object of this study is to investigate the effect of early bleb parameters measured by three-dimensional anterior-segment optical coherence tomography on the surgical success of trabeculectomy.

METHODS:

This retrospective study included 45 patients with 19 of exfoliation glaucoma, 17 of primary open angle glaucoma, 4 of neovascular glaucoma, 4 of uveitic glaucoma and 1 of glaucoma caused from familial amyloid polyneuropathy who underwent trabeculectomy. Bleb parameters, such as total bleb height, the position and the width of filtration openings on the scleral flap, bleb wall thickness, fluid-filled cavity height, and bleb wall intensity were assessed by three-dimensional anterior-segment optical coherence tomography 0.5 months after trabeculectomy, and were subjected to a Cox proportional hazard model as potential prognostic factors. Surgical success was defined as: IOP < 21 mmHg (A), < 18 mmHg (B), < 15 mmHg (C) with (qualified success) or without medication (complete success). Complete failure was defined as hypotony and additional glaucoma surgeries required.

RESULTS:

The width of filtration openings was identified as a prognostic factor for all criteria. By multivariable analysis, the width of the filtration openings was a prognostic factor in all criteria tested, and the preoperative IOP were significant prognostic factors for surgical success in qualified success in criteria B and C. Separate from the median widths of filtration openings, wide filtration opening showed significant survival ratio for qualified success in criteria A and B and for complete success in all criteria, respectively.

CONCLUSIONS:

The width of filtration opening at an early stage is a prognostic factor for surgical success of trabeculectomy.

• Authors: Utako Tsutsumi-Kuroda, Sachi Kojima, Ayako Fukushima, Kei-Ichi Nakashima, Keiichiro Iwao, Hidenobu Tanihara, Toshihiro Inoue
• Journal: BMC ophthalmology (BMC Ophthalmol) Vol. 19 Issue 1 Pg. 155 (Jul 19 2019) ISSN: 1471-2415 [Electronic] England
• PMID: 31324172 (Publication Type: Journal Article, Observational Study)

Topics

• Adult
• Aged
• Anterior Eye Segment (diagnostic imaging)
• Female
• Filtering Surgery (methods)
• Glaucoma (surgery)
• Humans
• Imaging, Three-Dimensional (methods)
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Multivariate Analysis
• Prognosis
• Retrospective Studies
• Tomography, Optical Coherence (methods)
• Trabeculectomy (methods)