Interobserver Variability of the Würzburg Bleb Classification Score

Klink, Thomas; Schrey, Sybille; Elsesser, Uta; Klink, Janine; Schlunck, Günther; Grehn, Franz

doi:10.1159/000161555

Cited by 23 publications

(21 citation statements)

References 30 publications

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“…The WBCS evaluates vascularization, corkscrew vessels, encapsulation and microcysts (table 1) [4,11]. Following the WBCS, most parameters were scored from 0 to 3 as compared to standard photographs [11].…”

Section: Methodsmentioning

confidence: 99%

“…Following the WBCS, most parameters were scored from 0 to 3 as compared to standard photographs [11]. The presence of microcysts was scored from 0 to 3 according to thirds of bleb area bearing microcysts, and bleb height was estimated as multiples of corneal thickness.…”

Section: Methodsmentioning

confidence: 99%

“…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]. The purpose of this retrospective study was to evaluate the prognostic value of the early postoperative WBCS for the outcome of trabeculectomy after 1 year.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…11 Three parameters (avascularity, corkscrew vessels, and microcysts) were scored from 0 to 3. The scoring was performed by a member of the study team at the time of follow-up assessment.…”

Section: Surgical Technique and Follow-upmentioning

confidence: 99%

A prospective randomised trial of trabeculectomy using mitomycin C vs an ologen implant in open angle glaucoma

Rosentreter

Schild

Jordan

et al. 2010

Eye

107

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“…Topical steroids were increased when postoperative bleb assessment revealed corkscrew vessels or increased vascularization. If signs of encapsulation appeared, 5-FU was injected subconjunctivally according to the Wuerzburg bleb classification score [13]. …”

Section: Methodsmentioning

confidence: 99%

Diurnal and Nocturnal Intraocular Pressure Fluctuations after Trabeculectomy

Klink

Praetorius²,

Leippi

et al. 2011

Ophthalmologica

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Purpose: The aim of this study was to compare diurnal and nocturnal intraocular pressure (IOP) fluctuations before and after trabeculectomy, and to evaluate the potential of trabeculectomy to even out IOP peaks. Materials and Methods: Retrospectively, 35 diurnal and nocturnal IOP curves of patients (35 eyes) who underwent trabeculectomy were analyzed. Diurnal and nocturnal IOP profiles were recorded from 06:00 to 23:59 and 00:00 to 06:00, respectively. Follow-up was at least 300 days. Two criteria for success were defined: (1) IOP ≤21 mm Hg and at least a 20% IOP reduction from baseline; (2) <18 mm Hg without medication. Results: The preoperative maximum diurnal and nocturnal IOP (IOP_max) were 26.5 ± 5.9 and 23.4 ± 5.2 mm Hg, respectively. The postoperative diurnal and nocturnal IOP_max were 16 ± 4.4 and 16 ± 5.4 mm Hg, respectively. Pre- to postoperative IOP reductions were statistically different (day 40% and night 32%; p < 0.001). Diurnal fluctuation was reduced significantly from 12.1 ± 4.2 mm Hg preoperatively to 5.6 ± 2.2 mm Hg postoperatively (reduction of 54%), and nocturnal fluctuation from 7.1 ± 4.5 to 3.9 ± 4.1 mm Hg (reduction of 46%, statistically insignificant due to large SD), respectively. Success criteria 1 and 2 were achieved in 71 and 54% of patients at daytime and in 63 and 57% at nighttime (no statistically significant difference detectable). Follow-up was 2.1 ± 1.7 years. Conclusions: Trabeculectomy achieves a leveling of IOP_max in the diurnal-nocturnal comparison. The preoperative fluctuations could be nearly bisected. Relating to the success criteria, the statistical analysis did not reveal a difference in the diurnal-nocturnal comparison.

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Interobserver Variability of the Würzburg Bleb Classification Score

Cited by 23 publications

References 30 publications

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

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

A prospective randomised trial of trabeculectomy using mitomycin C vs an ologen implant in open angle glaucoma

Diurnal and Nocturnal Intraocular Pressure Fluctuations after Trabeculectomy

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