Bleb needling in encapsulated filtering blebs: evaluation by optical coherence tomography

To evaluate the role of anterior segment optical coherence tomography (OCT) in describing the morphology and outcome of encapsulated filtering blebs after bleb needling.

Prospective assessment of 9 patients - before, 2 days and 6 months after filtering bleb needling with 5-FU - using slit-lamp examination, Goldmann tonometry and OCT.

Before the needling, the average internal height of the cyst was 1.3 +/- 0.8 mm. Two days after the needling procedure, the cyst collapsed in 5 patients. After 6 months, the average internal cyst height was 0.7 +/- 0.4 mm. All patients with a collapsed cyst at day 2 after needling had controlled regulated IOP without glaucoma medication.

The preoperative internal height of the cyst does not correlate with the outcome of the needling. A collapsed cyst at day 2 after needling is an indicator of controlled intraocular pressure, whereas a prominent cyst after 6 months indicates poor function.