Improvements in Optical Characteristics after Excision of an Overhanging Bleb Developed following Trabeculectomy (original) (raw)
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Influence of Overhanging Bleb on Corneal Higher-Order Aberrations after Trabeculectomy
Journal of Clinical Medicine, 2021
Recent advances in ocular aberrometry have revealed that ocular surgery increases ocular and corneal higher-order aberrations. This retrospective single-center study aimed to examine the effects of the overhanging bleb on corneal higher-order aberrations using a wavefront analyzer. We included 61 eyes from 50 patients with overhanging bleb after trabeculectomy with a fornix-based conjunctival flap using mitomycin C (overhanging bleb group) and 65 eyes from 54 glaucoma patients with no history of glaucoma surgery (control group). Corneal higher-order aberrations (total higher-order aberrations, coma aberrations, coma-like aberrations, spherical aberrations, and spherical-like aberrations) on a 4 mm pupil diameter were measured using the TOPCON KR-1W wavefront analyzer. Corneal coma aberrations were higher in the overhanging bleb group than in the control group (0.16 ± 0.13 μm and 0.10 ± 0.05 μm, respectively; p = 0.042). Corneal coma-like aberrations were also higher in the overhangi...
Eye, 1987
The bleb which develops following trabeculectomy may be diffuse or cystic in nature. Cystic blebs can be complicated by infection, leakage of aqueous, astigma tism, and problems related to contact lens wear, whereas diffuse blebs are not associated with such problems. We report a preliminary prospective photographic evaluation of bleb formation following each of three types of conjunctival incision: (a) fornix based (b) straight limbus based and (c) curved limbus based. The vascular pattern and morphology of the drainage bleb formed was dependent upon the type of conjunctival incision made. The fornix based flap was found most likely to give rise to a diffuse bleb with a normal vascular pattern.
Eye, 2017
Purpose To determine the long-term outcomes of same-site revision of failed filtering blebs with mitomycin C application. Patients and methods Noncomparative retrospective case series of 45 eyes of 39 patients. Main outcome measures were surgical success (≤ 21, ≤ 18, and ≤ 16 mm Hg reduction in intraocular pressure (IOP)). Other outcome measures included best-corrected visual acuity (VA), visual field loss, number of glaucoma medications, need for further interventions, time from surgery to recommencement of medications or interventions, and complications. Results Mean follow-up was 126 ± 59.6 months (range 16-227 months). The overall success proportion at last follow-up was 96% for IOP ≤ 21 mm Hg (criterion 1), 91% for IOP ≤ 18 mm Hg (criterion 2), and 84% for IOP ≤ 16 mm Hg (criterion 3). Absolute success at last follow-up was 64%, 38%, and 33% for criteria 1, 2, and 3, respectively. Mean baseline IOP was reduced from 24.2 ± 5.5 to 12.4 ± 5.5 mm Hg at last follow-up. Ten eyes (22%) had early and 3 (7%) eyes had late complications. None of these complications resulted in visual loss or surgery failure. Nine eyes (20%) required further glaucoma surgery. Nine eyes (20%) required further glaucoma laser. Conclusions Same-site, augmented, bleb revision is a safe and effective technique to control IOP and prevent further visual loss in patients with failed trabeculectomies.
Imaging of Trabeculectomy Blebs Using Anterior Segment Optical Coherence Tomography
Ophthalmology, 2007
Objective: To image trabeculectomy blebs using anterior segment optical coherence tomography (AS-OCT). Design: Prospective cross-sectional study. Participants: Fifty-five patients who had previously undergone trabeculectomy surgery. Methods: All blebs were imaged with a prototype of the AS-OCT. Standardized color monophotographs of blebs were also obtained. Blebs were assessed for the following qualitative features: bleb height, thickness of the conjunctiva in the bleb wall, presence of cystic spaces within the bleb wall, apposition of the scleral flap to underlying sclera, and patency of the internal ostium.
Türk Oftalmoloji Dergisi, 2015
Objectives: anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM). Materials and Methods: o parameters such as length, height and bleb wall thickness were assessed by AS-OCT; conjunctival epithelial-stromal cyst, structural network of conjunctival stroma and vascularisation were examined with IVCM. The relation between biomicroscopic morphological staging and bleb characteristics detected on AS-OCT and IVCM were assessed. Results: The mean age of the 28 patients (16 male, 12 female) was 57.2±15.9 (19 to 79) years. The mean time elapsed between surgery and examination was 29.2±19.2 (6 to 68) months. According to biomicroscopic appearance, 17 (60.7%) blebs were functional (13 diffuse, 4 ctional blebs, functional blebs were found to be superior in terms of biometric parameters on AS-OCT assessment (p<0.05). Higher number of epithelial and stromal cysts and less vascularisation were detected by IVCM in functional blebs when compared with non-functional blebs (p<0.05). Conclusion: Besides biomicroscopic examination, which is an easy and practical method for determining bleb morphology, cross-sectional images obtained by AS-OCT and IVCM provide objective data regarding internal structure and functional features of blebs.
Assessing the Status of Filtering Blebs at 5 Year Post- Trabeculectomy
Open Access Macedonian Journal of Medical Sciences, 2019
BACKGROUND: Glaucoma is a common cause of blindness in the world as well as in Vietnam. It is treated by many different methods but trabeculectomy is still the most popular and highly effective surgical method to treat this condition. AIM: To analyze the status of 5 years filtering blebs following trabeculectomy and to explore multiple factors associated with filtering blebs. METHODS: This is a retrospective, cross-sectional descriptive study. Eyes had been performed trabeculectomy for 5 years were included in these results. The filtering blebs were assessed using slit lamp and OCT. the OCT captured bleb area to evaluate fluid subconjunctival spaces, thickness and height of bleb and to evaluate the related factors RESULTS: A group of 106 primary glaucoma eyes of 97 patients (88 patients with 1 eye, 9 patients 2 eyes) had been performed trabeculectomy for 5 years were taken OCT anterior image. The proportion of female patients is 1.5 times that of male patients. IOP was controlled wi...
Trabeculectomy: is releasable suture trabeculectomy a cause of better bleb?
Romanian Journal of Ophthalmology, 2021
Purpose: To compare the outcome of fixed suture trabeculectomy with releasable suture trabeculectomy in terms of IOP control, bleb morphology, complications and need of antiglaucoma medication post-surgery. Methods: This study enlisted 200 cases of open angle glaucoma, whose IOP was uncontrolled despite maximal medication. Trabeculectomy was performed using releasable suture in one group of 100 patients and fixed suture in another group of 100 with mitomycin 0.02% in both groups. The study was randomized, the method being the simple randomization. Fornix based trabeculectomy was done in both groups. Two 10-0 nylon releasable sutures were used at two corners of the rectangular flap and one fixed 10-0 vicryl suture was used in the center of the flap. Two mattress sutures (conjunctiva cornea) were also used. Essentially, all the sutures were removed postoperatively over a period of 2-4 weeks depending upon the level of IOP. Mitomycin c 0.02% was used in both groups. Results: The mean p...
F1000Research, 2017
Background: To determine the predictive value of postoperative bleb morphological features and intraocular pressure (IOP) on the success rate of trabeculectomy. Methods: In this prospective interventional case series, we analyzed for one year 80 consecutive primary open angle glaucoma patients who underwent mitomycin-augmented trabeculectomy. Bleb morphology was scored using the Indiana bleb appearance grading scale (IBAGS). Success was defined as IOP ≤15 mmHg at 12 months. We applied a multivariable regression analysis and determined the area under the receiver operating characteristic curve (AUC). Results: The mean age of participants was 62±12.3 years in the success and 63.2±16.3 years in the failure group (P= 0.430) with equal gender distribution (P=0.911). IOPs on day 1, 7 and 30 were similar in both (P= 0.193, 0.639, and 0.238, respectively.) The AUC of IOP at day 1, day 7 and 30 for predicting a successful outcome was 0.355, 0.452, and 0.80, respectively. The AUC for bleb mor...
TRABECULECTOMY- BLEB BEHAVIOUR STUDY.
Purpose:- Trabeculectomy Surgery results were observed. Methods:- Prospective Study done at Government Medical College, Aurangabad between May 2005-Dec 2009. 46 eyes of 37 patients with Primary Glaucoma, uncontrolled medically were operated for Trabeculectomy surgery by a single surgeon .41 eyes had Open angle Glaucoma, 5 eyes had Narrow angle Glaucoma.Postop IOP, Bleb formation, Anterior chamber depth and other complications were noted. Follow-up was kept for 5 years. Results:- 40 eyes showed good postop IOP and formed anterior chamber and good healthy blebs. 2 eyes had flat anterior chambers and Anterior chamber formation with pressure pad bandage had to be given. 2 eyes had Raised IOP after 2 years and had to be reoperated with Trabeculectomy and Mitomicin C . Conclusion:- Satisfactory results were obtained with this surgical technique.Diffuse blebs ,less vascularised ,un-inflamed blebs filtered well.