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Related Experiment Videos

Comparison of two clinical Bleb grading systems.

Anthony P Wells1, N N Ashraff, R C Hall

  • 1Ophthalmology Unit, Department of Surgery and Anaesthesia, Wellington School of Medicine, Newtown, Wellington, New Zealand. twells@eyetext.net

Ophthalmology
|January 4, 2006
PubMed
Summary

The Moorfields Bleb Grading System (MBGS) and Indiana Bleb Appearance Grading Scale (IBAGS) are reproducible clinical tools for grading filtering surgery blebs. MBGS showed higher agreement for morphology and captured additional vascularity data.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Surgical Outcomes

Background:

  • Filtering surgery blebs are crucial indicators of surgical success in glaucoma management.
  • Standardized grading systems are needed for consistent clinical assessment of bleb morphology and function.

Purpose of the Study:

  • To compare the clinical reproducibility of two recently described grading systems for filtering surgery blebs: the Moorfields Bleb Grading System (MBGS) and the Indiana Bleb Appearance Grading Scale (IBAGS).

Main Methods:

  • An observational comparative study involving 24 glaucoma filtering blebs in 24 eyes of 17 patients.
  • Three observers prospectively evaluated blebs using both MBGS and IBAGS during slit-lamp examinations.
  • Analyses included interobserver agreement, repeatability, and intraclass correlation coefficients (ICC).

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Main Results:

  • Both MBGS and IBAGS demonstrated acceptable intrasystem agreement, with overall agreement rates above 78% for both systems.
  • Repeatability coefficients were comparable between MBGS (0.5-1.4) and IBAGS (0.8-1.2).
  • MBGS exhibited higher ICC values for morphologic features compared to IBAGS, and captured additional vascularity data.

Conclusions:

  • Both the MBGS and IBAGS are clinically reproducible methods for grading filtering surgery blebs with generally high interobserver agreement.
  • While both systems have minor deficiencies, MBGS offers comparable reproducibility to IBAGS, with added benefits in assessing bleb morphology and vascularity.