title: Characteristics of successful filtering blebs at 1 year after trabeculectomy using swept-source three-dimensional anterior segment optical coherence tomography.
abstract: OBJECTIVE
  To identify the cross-sectional characteristics of filtering blebs associated with intraocular pressure (IOP) control at 1 year after trabeculectomy with a square scleral flap and a fornix-based conjunctival flap.
  
  
  METHODS
  A retrospective consecutive case series study was conducted. Eighty-four eyes of 79 patients who had undergone primary trabeculectomy were included. Surgical success was defined as IOP ≤15 mmHg and a >20% reduction in IOP without glaucoma medication and without additional glaucoma surgery at 1 year after trabeculectomy. The subjects were classified into two groups according to whether surgery was successful or unsuccessful. Filtering blebs were examined using swept-source three-dimensional anterior segment optical coherence tomography and evaluated for the following quantitative parameters: maximum bleb height, maximum bleb wall thickness, and ratio of hypo-reflective space of the bleb wall.
  
  
  RESULTS
  Sixty-six eyes were determined to be successful and 18 eyes unsuccessful. Univariate analysis showed significant differences between the two groups regarding bleb height (P < 0.001), bleb wall thickness (P = 0.011), and ratio of hypo-reflective space of the bleb wall (P = 0.002). Multivariate logistic regression analysis confirmed that the bleb height was significantly associated with success in trabeculectomy [odds ratio 13.996 (95% confidence interval 1.184-165.420); P = 0.036].
  
  
  CONCLUSIONS
  A tall bleb with a thick hypo-reflective wall may be a feature of the well-functioning bleb.
authors.affiliation: Department of Ophthalmology, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-ku, Okayama, 700-8511, Japan. akiko.n@orange.megaegg.ne.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Narita
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Morizane
authors.affiliation: Department of Ophthalmology, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-ku, Okayama, 700-8511, Japan.
authors.forename: Tomoe
authors.initials: T
authors.lastname: Miyake
authors.affiliation: Department of Ophthalmology, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-ku, Okayama, 700-8511, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Seguchi
authors.affiliation: Shirai Eye Hospital, Mitoyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Baba
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Shiraga
mesh_terms: D000368:Aged; D000869:Anterior Eye Segment / Q000473:pathology*; D003228:Conjunctiva / Q000473:pathology / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D012590:Sclera / Q000473:pathology / Q000601:surgery; D013524:Surgical Flaps; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Anterior segment optical coherence tomography; Filtering bleb; Glaucoma; Trabeculectomy