Classification of filtering blebs in trabeculectomy: biomicroscopy and functionality

Picht, Greda; Grehn, Franz

doi:10.1097/00055735-199804000-00002

Cited by 178 publications

(173 citation statements)

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“…3,4,19,20 In addition, epithelial defects can be detected before apparent leakage occurs from the bleb wall. Therefore, we used a new classification of the late-onset bleb leakage: avascular or partial avascular bleb with an epithelial defect.…”

Section: Discussionmentioning

confidence: 99%

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Sodium hyaluronate eye drops prevent late-onset bleb leakage after trabeculectomy with mitomycin C

Sagara

Iida

Suzuki

et al. 2006

Eye

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Section: Discussionmentioning

confidence: 99%

“…19,20 Type 1 blebs had good filtration and were elevated with a relatively avascular appearance compared with the surrounding conjunctiva. Type 2 blebs had good filtration and were diffuse with a relatively avascular appearance compared with the surrounding conjunctiva.…”

Section: Eyementioning

confidence: 98%

Sodium hyaluronate eye drops prevent late-onset bleb leakage after trabeculectomy with mitomycin C

Sagara

Iida

Suzuki

et al. 2006

Eye

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“…1 Good intraocular pressure (IOP) control after filtration surgery is generally associated with the existence of a filtration bleb and its morphology. 2,3 Recognizing the importance of bleb appearance in relation to the surgical outcome, several classifications of bleb morphology based on slit-lamp grading have been proposed. 4,5 The visualization of internal bleb structures was first reported using ultrasound biomicroscopy (UBM).…”

Section: Introductionmentioning

confidence: 99%

Effect of laser suture lysis on filtration openings: a prospective three-dimensional anterior segment optical coherence tomography study

Cho

Kojima

Inoue

et al. 2015

Eye

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Purpose To investigate the effects of laser suture lysis (LSL) on filtration openings after trabeculectomy. Methods Prospective study analyzing the changes in the location and width of filtration openings, fluid cavity height, total bleb height, bleb wall thickness, and bleb wall intensity before and after LSL using threedimensional anterior segment optical coherence tomography (3D AS-OCT). Results Fourteen patients had clear scleral flap image analysis. As five patients underwent LSL twice and two patients underwent LSL thrice, 23 comparison studies were possible. After LSL the intraocular pressure (IOP) decreased (P = 0.0015) from 20.5 ± 5.3 to 14.9 ± 6.4 mm Hg, and the fluid cavity height increased significantly from 0.2 ± 0.2 mm to 0.3 ± 0.1 mm (P = 0.0094). Other bleb parameters were not significantly different when comparing before and after LSL. When the IOP reduction ratio was 425% following LSL, the width of the filtration openings on the LSL side, the total bleb height, and the fluid cavity height increased (P = 0.0273, 0.0342, and 0.0024, respectively). In multiple regression analysis the changes in fluid cavity height, the wall thickness, the wall intensity, and the width of the filtration opening were positively associated with the IOP reduction rate (P = 0.0428, 0.0226, 0.0420, and 0.0356, respectively). Conclusions 3D AS-OCT allowed a detailed examination of the internal morphology of filtration blebs and openings before and after LSL. The changes in the internal morphology were closely associated with the success of LSL to decrease IOP.

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“…Аналогичные наблюдения были сделаны и в процессе после-дующего исследования, результаты которого сви-детельствуют о том, что водянистая влага может проходить через конъюнктиву. Поэтому микро-кисты предлагается рассматривать в качестве благоприятного прогностического фактора хоро-шего функционирования фильтрационной подуш-ки, поскольку они могут играть роль каналов для пассажа водянистой влаги [34,39,46]. С помо-щью импрессионной цитологии с использованием методики иммунофлуоресценции и конфокальной микроскопии N. Amar (2008) продемонстрировал, что в поверхностном слое функционирующих фильтрационных подушек присутствуют много-численные бокаловидные клетки с характер-ными морфологическими изменениями, но рас-творимый муцин (MUC5AC) либо отсутствует вообще, либо присутствует в очень малом ко-личестве, в то время как бокаловидные клетки на границе фильтрационных подушек прокра-шиваются более гомогенно.…”

Section: обзоры/ Reviewsunclassified

The influence of local IOP-lowering therapy on the anterior segment tissues and outcome of glaucoma filtering surgery

Petrov

Юрьевич²,

Lovpache

et al. 2017

Ophthalmology Reports

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Nowadays, a wide choice of local IOP-lowering medications allows ensuring a successful intraocular pressure compensation and primary open angle glaucoma stabilization. However, taking into consideration a long term action of drugs on the ocular surface, even without clinical manifestations there is a direct inflammatory cells’ activation with mixed toxic and allergic changes, which is confirmed by histology, immune-histology, and impression cytology methods. Such chronic sub-clinical inflammation represent a potential risk of excessive fibroblast proliferation with subsequent rapid postoperative scarring of new outflow pathways and atypical filtration bleb formation. It is shown that there is a clear relationship between number of glaucoma drugs used, treatment duration, intensity of conjunctival infiltration with inflammatory cells and fibroblasts, and risk of episcleral fibrosis and subconjunctival scarring during post-op period. (For citation: Petrov SYu, Lovpache DzhN, Loskutov IA, Safronova DM. The influence of local IOP-lowering therapy on the anterior segment tissues and outcome of glaucoma filtering surgery. Ophthalmology Journal. 2017;10(4):41-47. doi: 10.17816/OV10441-47).

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Classification of filtering blebs in trabeculectomy: biomicroscopy and functionality

Cited by 178 publications

References 0 publications

Sodium hyaluronate eye drops prevent late-onset bleb leakage after trabeculectomy with mitomycin C

Sodium hyaluronate eye drops prevent late-onset bleb leakage after trabeculectomy with mitomycin C

Effect of laser suture lysis on filtration openings: a prospective three-dimensional anterior segment optical coherence tomography study

The influence of local IOP-lowering therapy on the anterior segment tissues and outcome of glaucoma filtering surgery

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