Bleb Morphology After Mitomycin-C Augmented Trabeculectomy: Comparison Between Clinical Evaluation and Anterior...

Area of Science:

• Ophthalmology
• Surgical Innovation
• Medical Imaging

Background:

• Glaucoma surgery, specifically trabeculectomy, aims to reduce intraocular pressure.
• Filtering blebs are crucial for surgical success but can develop complications like encapsulation.
• Early detection of bleb morphology changes is vital for successful postoperative management.

Purpose of the Study:

• To investigate the correlation between clinical appearance and AS-OCT findings of filtering blebs.
• To assess the utility of AS-OCT in identifying early signs of bleb complications post-trabeculectomy.
• To determine if AS-OCT can predict complications earlier than clinical evaluation.

Main Methods:

• Prospective study of 30 glaucoma patients undergoing trabeculectomy with mitomycin-C.
• Clinical and AS-OCT evaluations of filtering blebs at multiple postoperative time points (day 1 to week 12).
• Analysis of bleb wall thickness (BWT) and bleb cavity height (BCH) using AS-OCT.

Main Results:

• 63% of eyes had functioning blebs; intraocular pressure significantly decreased post-surgery.
• AS-OCT detected signs of encapsulation (thinner BWT, higher BCH) earlier than clinical assessment.
• Encapsulation was identified by AS-OCT at week 1-2, while clinically apparent at week 3-4, correlating with increased intraocular pressure.

Conclusions:

• AS-OCT provides insights into the deeper layers of filtering blebs, beyond clinical visualization.
• AS-OCT enables earlier detection of encapsulation characteristics, such as higher blebs with thinner walls.
• This early detection via AS-OCT may improve postoperative management and long-term outcomes after trabeculectomy.