[Studying the condition of filtering bleb after glaucoma surgery using optical coherence tomography]

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Outcomes

Background:

• Primary open-angle glaucoma (POAG) management often involves surgical intervention, such as trabeculectomy.
• The use of topical medications prior to surgery can influence post-operative outcomes.
• Filtering bleb (FB) function is critical for successful glaucoma surgery.

Purpose of the Study:

• To compare optical coherence tomography (OCT) findings of filtering bleb (FB) in primary open-angle glaucoma (POAG) patients using different pre-operative topical therapies.
• To assess the impact of preservatives in pre-operative glaucoma medications on FB healing and function.

Main Methods:

• Retrospective analysis of 82 POAG patients undergoing micro-invasive sinus trabeculectomy.
• Group 1: 50 patients received preservative-containing drugs; Group 2: 32 patients received preservative-free drugs.
• Filtering bleb evaluation using Visante AS-OCT and slit-lamp examination; intraocular pressure (IOPcc) measured with Ocular Response Analyzer (ORA) at 7 days, 1 month, and 3 months post-op.

Main Results:

• At 3 months, 76% of Group 1 and 78% of Group 2 had functioning FBs with IOPcc < 15.0 mm Hg.
• Non-functional FBs were observed in 24% of Group 1 and 22% of Group 2.
• Needling was required in 22% of Group 2 at 3 months, whereas OCT indicated needling in 8% of Group 1 at 1 week and 28% at 1 month.

Conclusions:

• Pre-operative use of preservative-containing medications is associated with faster scarring of the filtering bleb.
• Optical coherence tomography (OCT) is a valuable tool for early detection of FB scarring.
• OCT findings can guide the timely decision for post-operative interventions like needling.