Filtering bleb functionality: a clinical, anterior segment optical coherence tomography and in vivo confocal microscopy study.
J Glaucoma
; 17(4): 308-17, 2008.
Article
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| MEDLINE
| ID: mdl-18552617
ABSTRACT
PURPOSE:
To provide a microscopic and macroscopic analysis by a clinical, in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) assessment of filtering blebs after glaucoma surgery. MATERIAL ANDMETHODS:
We retrospectively analyzed 60 eyes of 48 glaucomatous patients by slit-lamp, IVCM, and AS-OCT examinations. Patients were divided into 2 groups successful blebs (group 1, 16 patients, 27 eyes) were defined as a one-third reduction in preoperative intraocular pressure without antiglaucoma medications and failed blebs (group 2, 32 patients, 33 eyes) as a less than one-third reduction in preoperative intraocular pressure without therapy. The examinations were performed from 1 to 96 months postoperatively.RESULTS:
Diffuse or cystic clinical patterns were indicative for good functionality whereas flat or encapsulation was indicative for poor functionality. When comparing successful with failed blebs, the IVCM analysis showed a greater number (P=0.014), density (P=0.009), and total area of epithelial microcysts (P=0.017) and a lower density of connective tissue (P=0.006). The AS-OCT analysis showed a lower degree of bleb wall reflectivity (P<0.001). A significant correlation was found between the clinical and AS-OCT parameters, particularly for the cystic (100%) and diffuse (74%) patterns.CONCLUSIONS:
All IVCM parameters did correlate well with the bleb functionality whereas, among the AS-OCT parameters, only the bleb wall reflectivity was significantly related to the filtering capability. Clinical and AS-OCT bleb classification showed a significant degree of concordance. As a consequence, simultaneous approach by clinical, microscopic, and tomographic assessment improves the clinician's ability in the postsurgery understanding and management of blebs.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Colgajos Quirúrgicos
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Vesícula
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Microscopía Confocal
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Conjuntiva
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Tomografía de Coherencia Óptica
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Segmento Anterior del Ojo
Tipo de estudio:
Observational_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Glaucoma
Asunto de la revista:
OFTALMOLOGIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Italia