title: In Vivo Confocal Microscopy and Biomicroscopy of Filtering Blebs After Trabeculectomy.
abstract: OBJECTIVE
  The aim of this study is to analyze filtering blebs (FBs) after trabeculectomy with in vivo confocal microscopy (IVCM) and slit-lamp biomicroscopy.
  
  
  METHODS
  IVCM using the Heidelberg Retina Tomograph/Rostock Cornea Module and biomicroscopic examination were performed in 67 FBs in 55 patients 3 months to 30 years postoperatively (mean, 3.2 ± 2.1 y). Although the blebs were evaluated by slit-lamp biomicroscopy, standardized FB classification was used.
  
  
  RESULTS
  Of the patients, 9 were female (16.3%) and 46 were male (83.7%), ranging in age from 32 to 81 (51.5 ± 13.2) years. The absence of vascularization and tortuous vessels and the presence of epithelial microcysts on the bleb were significantly correlated with good bleb function (P=0.001). IVCM findings significantly correlated with good bleb function, including the number of epithelial microcysts (P=0.002), the stromal cysts without capsule (P<0.001), minimal vascularization (P=0.002), and the absence of tortuous conjunctival vessels (P=0.003) and reticular and trabecular bleb patterns (P=0.01 and <0.01, respectively). In contrast, a hyperreflective condensed bleb stroma was significantly associated with bleb failure (P<0.001).
  
  
  CONCLUSIONS
  IVCM supports biomicroscopic evaluation as the mainstay for FB analysis and permits diagnostic imaging of FBs to evaluate and follow-up the bleb, differentiation between good and insufficient bleb function, and a microscopic analysis at a cellular level including the structural pattern of the bleb.
authors.affiliation: *Ophthalmology Department, Faculty of Medicine, Hitit University, Corum †Ophthalmology Clinic, Denizli State Hospital, Denizli ‡Ophthalmology Department, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Cagatay
authors.initials: C
authors.lastname: Caglar
authors.forename: Nafiz
authors.initials: N
authors.lastname: Karpuzoglu
authors.forename: Muhammed
authors.initials: M
authors.lastname: Batur
authors.forename: Tekin
authors.initials: T
authors.lastname: Yasar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D003228:Conjunctiva / Q000473:pathology* / Q000601:surgery; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D012189:Retrospective Studies; D066167:Slit Lamp; D013524:Surgical Flaps; D014130:Trabeculectomy; D014945:Wound Healing / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents