Visualization of Scleral Flap Patency in Glaucoma Filtering Blebs Using OCT

Le résumé fourni par la source

Purpose: To investigate the use of anterior-segment OCT (AS-OCT) to visualize the aqueous outflow pathway and patency of the scleral flap in glaucoma filtration surgery blebs. Design: Cross-sectional study. Subjects: Two hundred five filtering blebs of 112 patients with glaucoma who had undergone trabeculectomy (Trab, n = 97) or deep sclerectomy (DS, n = 108) surgery with/without mitomycin-C (MMC). Methods: Swept-source AS-OCT raster slices were used to image the Trab and DS blebs in sagittal and coronal planes using a standardized protocol. Bleb appearances were classified into 4 categories based on the scleral flap and sclerostomy/trabeculo-descemet window (TDW) appearance: A-sclerostomy/TDW not visible; B-sclerostomy/TDW visible but scleral flap indiscriminate from sclera; C-scleral flap distinct but edges adherent to surrounding sclera; D-scleral flap edges non adherent to surrounding sclera. Main Outcome Measures: Surgical outcomes were classified into complete success (CS) (intraocular pressure [IOP] ≤18 mmHg with no medications), qualified success (QS) (IOP ≤18 with medications), and failure (F) (IOP >18 mmHg). Results: = 0.02) cohorts, demonstrating the association of intraoperative MMC use with increased patency of the scleral flap. Conclusions: Swept-source AS-OCT may be used to visualize the position and patency of the sclerostomy/TDW and scleral flap in relation to surrounding structures in both sagittal and coronal planes. Although free scleral flap edges are primarily correlated with MMC use, it may also correlate with surgical success. Anterior-segment OCT may be used to complement subjective bleb grading at the slit lamp in the assessment of filtering blebs. Financial Disclosures: The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.