Influence of argon laser trabeculoplasty on transforming growth factor-beta 2 concentration and bleb scarring following trabeculectomy

Wimmer, Iris; Welge-Luessen, Ulrich; Picht, Greda; Grehn, Franz

doi:10.1007/s00417-003-0721-x

Cited by 19 publications

(14 citation statements)

References 27 publications

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“…Since then, several other studies employed the WBCS to grade bleb morphology [5, 9, 12, 13]. The score was used to guide treatment decisions in postoperative follow-up, and to give a prognosis of bleb function and surgical outcome [9, 10].…”

Section: Discussionmentioning

confidence: 99%

“…The Würzburg bleb classification score [5] (WBCS) was designed to allow for a well-structured assessment of filtering bleb morphology. Since 1998, the WBCS is regularly used in experimental investigations and clinical routine, especially as a basis for intensified postoperative care [1,9,10,11,12,13]. Recently published grading systems for filtering blebs use criteria similar to the WBCS [2, 3, 8].…”

Section: Introductionmentioning

confidence: 99%

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Interobserver Variability of the Würzburg Bleb Classification Score

et al. 2008

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Background: The Würzburg bleb classification score (WBCS) serves to assess filtering blebs in a standardized fashion. The purpose of this prospective masked agreement study was to evaluate the WBCS interobserver variability. Methods: The WBCS provides a scheme to grade clinical bleb morphology. It evaluates the following parameters: vascularity, corkscrew vessels, encapsulation, microcysts and bleb height. Thus, 113 eyes of 104 consecutive patients at various times after surgery were examined (slit lamp biomicroscopy) by 3 ophthalmologists with each observer being unaware of the findings reported by the others. To calculate the interobserver variability of the WBCS, the interobserver consistency and absolute agreement were determined with an intraclass correlation coefficient (ICC) using a 2-way random model. Results: The ICC values of a single rater’s judgment were: vascularity +0.62, corkscrew vessels +0.67, encapsulation +0.63, bleb height +0.53, microcysts +0.52 and total score +0.74. The ICC values of the mean of all 3 raters were: +0.83 vascularity, +0.86 corkscrew vessels, +0.84 encapsulation, +0.77 bleb height, +0.76 microcysts and +0.90 total score. Conclusion: The WBCS is a bleb morphology score with high levels of interobserver consistency and absolute agreement in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Interobserver Variability of the Würzburg Bleb Classification Score

et al. 2008

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“…The Wuerzburg bleb classification score (WBCS) aims at an objective and standardized assessment of the developing filtering bleb after trabeculectomy, in order to detect and treat bleb scarring at the earliest stage [4]. Since 1998, the WBCS has been used in clinical studies and clinical routine, as a basis for intensified postoperative care [7,8,9,10]. The WBCS has a low interobserver variability and provides a good basis for consistent clinical decisions [11].…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of the Wuerzburg Bleb Classification Score for the Outcome of Trabeculectomy

Klink¹,

Kann²,

Ellinger³

et al. 2010

Ophthalmologica

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Background: The Wuerzburg bleb classification score (WBCS) aims at an objective and standardized assessment of the developing filtering bleb after trabeculectomy, in order to detect and treat bleb scarring at the earliest possible stage of development. The purpose of this retrospective study was to evaluate the prognostic value of the early postoperative WBCS for the long-term outcome of trabeculectomy. Methods: The WBCS is a grading system for clinical bleb morphology. It evaluates the following parameters: vascularization, corkscrew vessels, encapsulation and microcysts. The WBCS of 113 eyes of 113 consecutive patients after trabeculectomy was determined 1 day, 1 and 2 weeks, 3, 6 and 12 months after surgery. Complete success was defined as an intra-ocular pressure (IOP) <21 mm Hg and >20% pressure reduction without glaucoma medication after 1 year. Results: A complete success rate of 73.9% and a qualified success rate of 82.4% were achieved 1 year after surgery. The average total bleb score during follow-up in the success group was always higher than in the failure group, but there was no statistically significant difference at any time. The bleb average score for eyes with an IOP of ≤12 mm Hg after 2 weeks was significantly higher (p = 0.005) than for eyes with an IOP ≧13 mm Hg at the end of follow-up. Conclusion: Patients with a higher early WBCS postoperatively had a significantly lower IOP 1 year after surgery. However, the study could not reveal a certain prognostic value of the early total bleb score using the WBCS for the long-term complete success of trabeculectomy.

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“…[33][34][35][36] Increased levels of active TGF-b 2 have been reported as well in diabetes 28,37 especially following photocoagulation. 29 To avoid influences on active TGF-b 2 levels in the aqueous humour by these frequently accompanying diseases, we decided at the beginning of this study that glaucoma and diabetes were exclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

Decreased active TGF-β2 levels in the aqueous humour during immune reactions following penetrating keratoplasty

Maier¹,

Broszinski²,

Heizmann³

et al. 2007

Eye

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Influence of argon laser trabeculoplasty on transforming growth factor-beta 2 concentration and bleb scarring following trabeculectomy

Abstract: ALT appears to increase the risk of scarring in XFS patients because of increased levels of activated TGF-beta 2.

Cited by 19 publications

References 27 publications

Interobserver Variability of the Würzburg Bleb Classification Score

Interobserver Variability of the Würzburg Bleb Classification Score

The Prognostic Value of the Wuerzburg Bleb Classification Score for the Outcome of Trabeculectomy

Decreased active TGF-β2 levels in the aqueous humour during immune reactions following penetrating keratoplasty

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