Correlation between the early morphological appearance of filtering blebs and outcome of trabeculectomy with mitomycin C.
OBJECTIVE
To correlate the morphologic appearance of filtering blebs in the early postoperative period with the outcome of trabeculectomy with mitomycin C (MMC) during the first postoperative year.


METHODS
In a prospective study, the morphologic appearance of filtering blebs after primary trabeculectomy with adjunctive MMC (0.1 mg/ml for 5 minutes intra-operatively) was classified; 49 eyes of 49 patients were examined preoperatively, 1 and 3 days, 1 and 2 weeks, 1, 3, 6, and 12 months postoperatively. Status of filtering bleb, intraocular pressure (IOP), and number of medications were recorded.


RESULTS
One year after surgery all patients had IOP < or = 21; 6 patients received antiglaucoma medication. One eye required needling of the filtering bleb because of encapsulation. During the first postoperative year, eyes with conjunctival subepithelial micro cysts, observed in the first and the second postoperative week, had significantly lower mean IOP, than eyes without (11.1 mm Hg vs. 13.9 mm Hg; p:0.0043, ANOVA). Eyes with corkscrew vessels, observed in the first and the second postoperative week, had significantly higher mean IOP, than eyes without during the first postoperative year (13.4 mm Hg vs. 11.7 mm Hg; p:0.0141, ANOVA).


CONCLUSIONS
Classification of filtering blebs after trabeculectomy with MMC may help to disclose patients with an increased failure risk.
Sacu
Stefan
S
Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria.
Rainer
Georg
G
Findl
Oliver
O
Georgopoulos
Michael
M
Vass
Clemens
C
D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000098:blood supply / Q000473:pathology*; D017889:Exfoliation Syndrome / Q000601:surgery; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D011446:Prospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D014945:Wound Healing
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin