Stratus optical coherence tomography study of filtering blebs after primary trabeculectomy with a fornix-based conjunctival flap.
OBJECTIVE
To investigate the relationship between filtering bleb function and Stratus optical coherence tomography (OCT) images.


METHODS
We studied 72 eyes of 65 consecutive patients who had a fornix-based conjunctival flap in primary trabeculectomy with mitomycin C (MMC). Filtering blebs with various types of glaucoma were examined using Stratus OCT. Success rates were defined as intraocular pressure (IOP) < or = 15 mmHg and IOP reduction > or = 25% without medication or additional surgery. Success rates among classified groups were compared using Kaplan-Meier survival curves and the log-rank test.


RESULTS
Blebs were classified into three different categories on the basis of the following Stratus OCT patterns: cystoid type (multiple cysts inside the bleb; 17 eyes), diffuse type (low to high reflective areas that were mixed inside the bleb; 31 eyes) and layer type (medium to high reflective layer inside the bleb; 24 eyes). Success rates in the cystoid-, diffuse- and layer-type blebs were 94%, 97% and 75% (P = 0.02), respectively.


CONCLUSIONS
In trabeculectomy with MMC and a fornix-based conjunctival flap, there is a significant association between the success rates and the postoperative Stratus OCT findings of filtering blebs.
Hirooka
Kazuyuki
K
Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan. kazuyk@med.kagawa-u.ac.jp
Takagishi
Mai
M
Baba
Tetsuya
T
Takenaka
Hirokazu
H
Shiraga
Fumio
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001768:Blister / Q000473:pathology*; D003228:Conjunctiva; D017889:Exfoliation Syndrome / Q000601:surgery; D005260:Female; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D015812:Glaucoma, Angle-Closure / Q000601:surgery; D006801:Humans; D057066:Low Tension Glaucoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D011184:Postoperative Period; D013524:Surgical Flaps; D041623:Tomography, Optical Coherence; D014130:Trabeculectomy; D014605:Uveitis / Q000150:complications
D016685:Mitomycin