Imaging of Trabeculectomy Blebs Using Anterior Segment Optical Coherence Tomography

Singh, Mandeep S.; Chew, Paul; Friedman, David S.; Nolan, Winifred; Sée, J.; Smith, Scott D.; Zheng, Ce; Foster, Paul J.; Aung, Tin

doi:10.1016/j.ophtha.2006.05.078

Cited by 166 publications

(170 citation statements)

References 24 publications

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“…Obtaining preoperative knowledge of bleb structures appears feasible in planning safe surgery beforehand to reduce the risk of complications from manipulation. Noninvasive approaches to examine bleb include ultrasound biomicroscopy and AS-OCT. 1,2 In our case, multiloculated bleb structure of dissecting portion apart from the main cystic bleb was confirmed by preoperative AS-OCT imaging and histological study. Previous reports of overhanging bleb [3][4][5] stated that leaking was not a common complication even without the safety measure or suture.…”

Section: Commentsupporting

confidence: 65%

Surgical outcomes of intermittent exotropia associated with concomitant hypertropia including simulated superior oblique palsy after horizontal muscles surgery only' by YA Cho and S-H Kim

Altıntaş

Raza

2008

Eye

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Section: Commentsupporting

confidence: 65%

Surgical outcomes of intermittent exotropia associated with concomitant hypertropia including simulated superior oblique palsy after horizontal muscles surgery only' by YA Cho and S-H Kim

Altıntaş

Raza

2008

Eye

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“…9,13 External bleb classifications 10,11 have been described to address the glaucoma surgery functionality and prognosis but they cannot assess the intrascleral bleb. Recently, the AS-OCT has been used to evaluate filtering blebs after trabeculectomy [2][3][4] and DS with collagen scleral implant. 5,6 The objective of this study was to perform an analysis of the relationship between DS blebs height with three different intrascleral implants and IOP using the Visante AS-OCT.…”

Section: Discussionmentioning

confidence: 99%

“…1 Anterior segment optical coherence tomography (AS-OCT) has been used to evaluate blebs after filtrating glaucoma surgery. [2][3][4][5][6] Glaucoma surgery long-term success is determined by the development of an adequate filtering bleb in both trabeculectomy and deep sclerectomy (DS).…”

Section: Introductionmentioning

confidence: 99%

A comparison of intrascleral bleb height by anterior segment OCT using three different implants in deep sclerectomy

Fernández-Buenaga

Rebolleda

Casas-Llera

et al. 2012

Eye

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Purpose To compare intrascleral blebs characteristics after deep sclerectomy (DS) with three intrascleral implants using the Visante anterior segment optical coherence tomography. Methods This is a cross-sectional study including 60 eyes of 51 patients that underwent DS with Sk-Gel, Esnoper, and Aquaflow implant. Intraocular pressure (IOP) measurement, slit-lamp examination, and Visante scans were performed the same day in all the patients. Visante scans were done through the intrascleral bleb at 451, 901, and 1351 and the bleb height was measured. Results Sk-Gel was used in 19 eyes (31.66%), Esnoper in 22 eyes (36.66%), and Aquaflow in 19 eyes (31.66%). The median time lapsed from the surgery was 15.50 months 25th and 75th percentiles (p 25 8.25; p 75 20). The median IOP was 13 mm Hg (p 25 10; p 75 15), with no significant differences among implants (P ¼ 0.232). Overall, the correlation between the scleral bleb height and the IOP was statistically significant at 451 (r ¼ À0.359; P ¼ 0.004), 901 (r ¼ À0.410; P ¼ 0.001), and 1351 (r ¼ À0.417; P ¼ 0.001). However, Sk-Gel did not show any statistically significant correlation between the scleral height and IOP whereas the other two groups (Esnoper and Aquaflow) showed a significant correlation. There were no differences in the bleb height among implants. Conclusion There was a moderate inverse correlation between the scleral bleb height and the IOP measurement after DS with Esnoper and Aquaflow implants. There were no differences in bleb height among the three implants.

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Section: Introductionmentioning

confidence: 99%

“…7,8 However, the previous studies used two-dimensional (2D) OCT, so the filtration openings could not be identified because of the limited number of sections (a radial section perpendicular to the limbus and/or a section tangential to the limbus through the site of maximal bleb elevation). 7,8 With three-dimensional (3D) AS-OCT, aqueous outflow openings at the margin of scleral flaps can be visualized more clearly using en face OCT images. 9,10 In our previous studies we obtained 512 3D scans that were rotated using newly developed software (CASIA bleb-assessment software, Tomey) and matched with reconstructed C-scan images (tomographic image of the slice plane perpendicular to the depth direction) to precisely identify the filtration openings on the scleral flap.…”

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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Imaging of Trabeculectomy Blebs Using Anterior Segment Optical Coherence Tomography

Cited by 166 publications

References 24 publications

Surgical outcomes of intermittent exotropia associated with concomitant hypertropia including simulated superior oblique palsy after horizontal muscles surgery only' by YA Cho and S-H Kim

Surgical outcomes of intermittent exotropia associated with concomitant hypertropia including simulated superior oblique palsy after horizontal muscles surgery only' by YA Cho and S-H Kim

A comparison of intrascleral bleb height by anterior segment OCT using three different implants in deep sclerectomy

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

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