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Quantitative assessment of changes in trabeculectomy blebs after laser suture lysis using anterior segment coherence
Chelvin C A Sng1, Mandeep Singh, Paul Tec Kuan Chew
1Department of Ophthalmology, National University Health System, Singapore.
Purpose:
To quantify changes in bleb morphology after laser suture lysis (LSL) using anterior segment optical coherence tomography (AS-OCT).
Patients And Methods:
This was a prospective observational case series of patients who underwent trabeculectomy surgery with mitomycin-C and required subsequent LSL. Subjects were assessed before and immediately after LSL, and at 3 months after LSL. At each visit, a standardized cross-sectional AS-OCT image of the bleb was obtained, from which a masked observer measured bleb height (hB), cavity height (hC), wall cross sectional area (AW), cavity cross sectional area (AC), and bleb cross sectional area (AB) using custom software.
Results:
Twenty-five subjects (25 eyes) were examined. LSL was performed at a mean of 21.5±16.3 days after trabeculectomy. Immediately after LSL, there was a significant increase in mean hB (P=0.026) and mean hC (P=0.45) from pre-LSL. At 3 months after LSL, there was a significant increase in mean hB (P=0.003), mean AC (P=0.047), and mean AB (P=0.006) as compared with before LSL. Increase in hB and hC immediately after LSL was predictive of outcome at month 3.
Conclusions:
AS-OCT was able to quantify changes in bleb morphology after LSL, some of which were predictive of eventual outcome.
