title: Evaluation of filtering blebs exhibiting transconjunctival oozing using anterior segment optical coherence tomography.
abstract: OBJECTIVE
  To explore the features of filtering blebs exhibiting transconjunctival oozing via three-dimensional anterior segment optical coherence tomography (3D AS-OCT).
  
  
  METHODS
  In this cross-sectional study, 131 eyes of 131 patients exhibiting filtering blebs were examined. Of those, 20 eyes were excluded as flat-shaped, non-functioning bleb. Transconjunctival oozing was defined as transconjunctival aqueous egress evident on the bleb surface, in the absence of any point leak observable using a slit-lamp, as confirmed by application of digital pressure. Total bleb height, the height of the fluid-filled cavity, and bleb wall thickness and density were measured using 3D AS-OCT. Patient age, the etiology of glaucoma, postoperative follow-up period, number of glaucoma medication classes prescribed, intraocular pressure (IOP), grade of bleb vascularity, and bleb parameters were compared in eyes with and without bleb oozing.
  
  
  RESULTS
  Sixty (54.0 %) of 111 eyes excluding non-functioning flat blebs exhibited oozing; mean IOP value (11.7 ± 4.5 vs. 14.8 ± 4.0 mmHg) and bleb vascularity grade (1.5 ± 0.7 vs. 2.4 ± 1.0) were lower than those of eyes without oozing. Total bleb height (1.1 ± 0.4 vs. 0.9 ± 0.4 mm), bleb wall thickness (0.7 ± 0.4 vs. 0.5 ± 0.3 mm), and bleb wall density (131.3 ± 45.7 vs. 180.9 ± 39.8 optical density units) differed significantly between the two groups (oozing vs. non-oozing).
  
  
  CONCLUSIONS
  Transconjunctival oozing after trabeculectomy with MMC was associated with a low IOP, low-level bleb vascularity, an elevated total bleb height, a thicker bleb wall, and low bleb wall density.
authors.affiliation: Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
authors.forename: Kei-Ichi
authors.initials: K
authors.lastname: Nakashima
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Ayako
authors.initials: A
authors.lastname: Fukushima
authors.forename: Saori
authors.initials: S
authors.lastname: Hirakawa
authors.forename: Sachi
authors.initials: S
authors.lastname: Kojima
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Tanihara
mesh_terms: D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage; D001082:Aqueous Humor / Q000378:metabolism*; D003228:Conjunctiva / Q000502:physiology* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005402:Fistula; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D041623:Tomography, Optical Coherence / Q000379:methods*; D014065:Tonometry, Ocular; D014130:Trabeculectomy
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin