title: Quantitative assessment of changes in trabeculectomy blebs after laser suture lysis using anterior segment coherence tomography.
abstract: OBJECTIVE
  To quantify changes in bleb morphology after laser suture lysis (LSL) using anterior segment optical coherence tomography (AS-OCT).
  
  
  METHODS
  This was a prospective observational case series of patients who underwent trabeculectomy surgery with mitomycin-C and required subsequent LSL. Subjects were assessed before and immediately after LSL, and at 3 months after LSL. At each visit, a standardized cross-sectional AS-OCT image of the bleb was obtained, from which a masked observer measured bleb height (hB), cavity height (hC), wall cross sectional area (AW), cavity cross sectional area (AC), and bleb cross sectional area (AB) using custom software.
  
  
  RESULTS
  Twenty-five subjects (25 eyes) were examined. LSL was performed at a mean of 21.5±16.3 days after trabeculectomy. Immediately after LSL, there was a significant increase in mean hB (P=0.026) and mean hC (P=0.45) from pre-LSL. At 3 months after LSL, there was a significant increase in mean hB (P=0.003), mean AC (P=0.047), and mean AB (P=0.006) as compared with before LSL. Increase in hB and hC immediately after LSL was predictive of outcome at month 3.
  
  
  CONCLUSIONS
  AS-OCT was able to quantify changes in bleb morphology after LSL, some of which were predictive of eventual outcome.
authors.affiliation: Department of Ophthalmology, National University Health System, Singapore.
authors.forename: Chelvin C A
authors.initials: CC
authors.lastname: Sng
authors.forename: Mandeep
authors.initials: M
authors.lastname: Singh
authors.forename: Paul Tec Kuan
authors.initials: PT
authors.lastname: Chew
authors.forename: Cheryl S
authors.initials: CS
authors.lastname: Ngo
authors.forename: Ce
authors.initials: C
authors.lastname: Zheng
authors.forename: Tin A
authors.initials: TA
authors.lastname: Tun
authors.forename: Jovina L S
authors.initials: JL
authors.lastname: See
authors.forename: Marcus
authors.initials: M
authors.lastname: Ang
authors.forename: Seng Chee
authors.initials: SC
authors.lastname: Loon
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
mesh_terms: D000477:Alkylating Agents / Q000008:administration & dosage; D001082:Aqueous Humor / Q000378:metabolism; D003228:Conjunctiva / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005901:Glaucoma / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D018918:Phacoemulsification; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery; D013524:Surgical Flaps / Q000473:pathology*; D013536:Suture Techniques; D041623:Tomography, Optical Coherence; D014130:Trabeculectomy
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin