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

Abstract

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.

Conventional trabeculectomy versus trabeculectomy with the Ex-PRESS^® mini-glaucoma shunt: differences in postoperative interventions

“…The most suitable timing for laser suture lysis is a very important factor affecting postoperative results. 26 In our study, the mean of postoperative IOP was slightly lower than previous reports. Cutting the threads early might contribute for low postoperative IOP.…”

Evaluation of Early Postoperative Intraocular Pressure for Success after Ex-Press Surgery

“…To sufficiently lower the IOP at the early postoperative period, early postoperative interventions such as laser suture lysis are necessary. 4,25,26 The timing of laser suture lysis is very important for trabeculectomy; there are reports that laser suture lysis within 7 ± 10 days lowers postoperative IOP. 4,27–29 We previously reported that the mean period before undergoing laser suture lysis of the first thread after Ex-Press surgery was 3.4 days.…”

Evaluation of Functional Filtering Bleb Using Optical Coherence Tomography Angiography

“…This classification was related to the OCT cube scan area (4.5 × 4.5 mm). According to a previous study on the relationship between the location of filtration opening using AS-OCT and laser suture lysis,32 group analysis was performed to determine whether these bleb location differences would have an impact. Comparison of correlation between color density, and brightness density with grades from the IBAGS and MBGS were performed using a Fisher z test.…”