Filtering bleb evaluation with slit-lamp-adapted 1310-nm optical coherence tomography.
OBJECTIVE
Investigation of slit-lamp-adapted 1310-nm optical coherence tomography (OCT) as an in vivo imaging device in the postoperative course of glaucoma surgery.


METHODS
Postoperative images of filtering blebs and deep sclerectomies and their healing processes were qualitatively evaluated with a slit-lamp-adapted anterior segment OCT (AS-OCT; Heidelberg Engineering, Heidelberg, Germany) in 28 patients. Ophthalmologic examinations included slit-lamp examination, applanation tonometry, and slit-lamp photography. The OCT scans were qualitatively correlated with the morphologic and functional outcome of the filtering bleb.


RESULTS
1310-nm OCT was able to demonstrate the internal structure and the dimensions of filtering blebs, as well as the scleral flap and the deep sclerectomy location including Descemet membrane. Functioning filtering blebs showed a low OCT signal, small fluid-filled cysts, superficial microcystic layer, and a slack internal texture. High internal reflectivity indicated an earlier scarring of the filtering bleb. Nonfunctioning filtering blebs delivered a high OCT signal, no or few cysts, and a dense internal texture. These different OCT patterns correlated with the clinical outcome.


CONCLUSIONS
Slit-lamp-adapted 1310-nm OCT allowed the noncontact observation and documentation of the postoperative healing course of filtering blebs after glaucoma surgery. Internal structures of the filtering bleb and deep sclerectomies could be visualized. Functioning and dysfunctioning filtering blebs delivered different OCT pattern and correlated with the clinical outcome. This could be a new way to assess the postoperative healing process with the possibility of earlier intervention in cases of impending scarring.
Müller
Maya
M
University Eye Hospital Schleswig-Holstein, Lübeck, Germany. mayamueller@gmx.de
Hoerauf
Hans
H
Geerling
Gerd
G
Pape
Stefanie
S
Winter
Christian
C
Hüttmann
Gereon
G
Birngruber
Reginald
R
Laqua
Horst
H
D001768:Blister / Q000175:diagnosis*; D003229:Conjunctival Diseases / Q000175:diagnosis*; D018463:Filtering Surgery; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D010865:Pilot Projects; D011183:Postoperative Complications; D011184:Postoperative Period; D041623:Tomography, Optical Coherence / Q000379:methods*; D014129:Trabecular Meshwork / Q000601:surgery