Evaluation of filtering blebs using the 'Wuerzburg bleb classification score' compared to clinical findings.
BACKGROUND
To determine the agreement between intraocular pressure and the 'Wuerzburg bleb classification score', as well as between single items of the score and intraocular pressure. Interobserver variability was analyzed.


METHODS
57 post-trabeculectomy eyes were included. Colour photographs were used to score the filtering bleb in accordance to the Wuerzburg bleb classification score by two different examiners. At the same visit, clinical data such as intraocular pressure, best corrected visual acuity, slit lamp biomicroscopy and medical history were obtained by another examiner.


RESULTS
After trabeculectomy, 42 out of 57 eyes (73.7%) reached the target pressure (≤ 21mmHg, and intraocular pressure reduction of at least 20%, without antiglaucoma medication, and without any additional intervention). Fair agreement was found between intraocular pressure and Wuerzburg bleb classification score ≥ 8 points and ≥ 7 points (kappa 0.24 and 0.27, respectively). Analyzing the subgroups of the morphological criteria, best agreement was found between occurrence of microcysts and target intraocular pressure (к 0.22-0.34).


CONCLUSIONS
Evaluating filtering blebs after trabeculectomy by using the Wuerzburg bleb classification score is a good technique for predicting intraocular pressure control in eyes attaining a minimum score of seven points. The presence of microcysts on the filtering bleb predicts that the eye is likely to attain target pressure.
University of Zurich Medical Faculty, Zurich, Switzerland.
Sandra
S
Furrer
Marcel N
MN
Menke
Jens
J
Funk
Marc
M
Töteberg-Harms
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001768:Blister / Q000145:classification* / Q000503:physiopathology; D003229:Conjunctival Diseases / Q000473:pathology* / Q000601:surgery; D005260:Female; D018463:Filtering Surgery; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D014130:Trabeculectomy / Q000009:adverse effects; D014792:Visual Acuity / Q000502:physiology