Stratus optical coherence tomography study of filtering blebs after primary trabeculectomy with a fornix-based...

To investigate the relationship between filtering bleb function and Stratus optical coherence tomography (OCT) images.

We studied 72 eyes of 65 consecutive patients who had a fornix-based conjunctival flap in primary trabeculectomy with mitomycin C (MMC). Filtering blebs with various types of glaucoma were examined using Stratus OCT. Success rates were defined as intraocular pressure (IOP) < or = 15 mmHg and IOP reduction > or = 25% without medication or additional surgery. Success rates among classified groups were compared using Kaplan-Meier survival curves and the log-rank test.

Blebs were classified into three different categories on the basis of the following Stratus OCT patterns: cystoid type (multiple cysts inside the bleb; 17 eyes), diffuse type (low to high reflective areas that were mixed inside the bleb; 31 eyes) and layer type (medium to high reflective layer inside the bleb; 24 eyes). Success rates in the cystoid-, diffuse- and layer-type blebs were 94%, 97% and 75% (P = 0.02), respectively.

In trabeculectomy with MMC and a fornix-based conjunctival flap, there is a significant association between the success rates and the postoperative Stratus OCT findings of filtering blebs.