Glaucoma Filtering Bleb Analysis Before and After Aponeurotic Blepharoptosis Surgery.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Oculoplastic Surgery

Background:

• Glaucoma filtering blebs are crucial for intraocular pressure management.
• Blepharoptosis can coexist with glaucoma, potentially affecting visual fields.
• Surgical interventions for blepharoptosis in patients with filtering blebs require careful consideration of safety and impact on the bleb.

Purpose of the Study:

• To evaluate the safety and effectiveness of transcutaneous levator aponeurotic ptosis surgery.
• To assess the impact of this surgery on the morphology of filtering blebs.
• To determine changes in intraocular pressure following blepharoptosis surgery in patients with existing filtering blebs.

Main Methods:

• Retrospective case series of 7 patients (9 eyes) with filtering blebs post-trabeculectomy.
• Patients underwent transcutaneous levator aponeurotic advancement.
• Evaluated margin reflex distance-1, intraocular pressure, and filtering bleb morphology (volume, height, wall thickness) using AS-OCT before and after surgery.

Main Results:

• Significant improvement in margin reflex distance-1 (0.7 mm to 3.3 mm, p < 0.0001).
• No significant changes in intraocular pressure (12.9 mm Hg to 12.7 mm Hg).
• Anterior segment optical coherence tomography revealed no significant alterations in filtering bleb morphology; no intraoperative complications; one postoperative corneal disorder, no bleb infection or damage.

Conclusions:

• Transcutaneous levator aponeurotic ptosis surgery is safe in patients with glaucoma filtering blebs.
• The procedure is unlikely to adversely affect filtering bleb morphology or intraocular pressure in the short term.
• This surgical approach offers a safe option for correcting blepharoptosis without compromising glaucoma management.