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Abstract #8548 Published in IGR 5-1
Clinical characteristics and leakage of functioning blebs after trabeculectomy with mitomycin-C in primary glaucoma patients
Hu CY; Matsuo H; Tomita G; Suzuki Y; Araie M; Shirato S; Tanaka SOphthalmology 2003; 110: 345-352
PURPOSE: To describe the clinical characteristics of functioning blebs in Japanese glaucoma patients after primary trabeculectomy with adjunctive mitomycin-C (MMC) and to correlate their association with postoperative bleb leakage. DESIGN: A prospective, observational case series. PARTICIPANTS: One hundred and sixty-two glaucoma patients who had undergone primary trabeculectomy with MMC at the University of Tokyo Hospital at least three months earlier were examined between December 1997 and February 1998. METHODS: A predesigned data form was completed at each visit. Ophthalmological examinations included Goldmann applanation tonometry, slit-lamp examination, and Seidel tests with and without digital ocular pressure (DOP). MAIN OUTCOME MEASURES: Properties of the functioning bleb, including bleb appearance, thickness of bleb wall, dimensions of bleb and avascular area, and leakage status with and without DOP. RESULTS: In 162 Japanese patients, 162 eyes with functioning blebs were included. There were no differences in bleb characteristics between the different types of primary glaucoma. With a long postoperative duration, blebs tended to be thinner (p = 0.024). With DOP, the leaking rate increased from 3.1-5.6%, and the oozing rate from 11.1-35.8% (p < 0.001). Logistic regression analysis indicated that the larger the avascular area, the more likely the bleb leaked without DOP (p = 0.016). When DOP was applied, leakage was more likely to occur in the blebs with a long postoperative duration (p = 0.002) or with a large avascular area (p < 0.001). CONCLUSIONS: The clinical characteristics of filtering blebs were similar in Japanese patients with different types of primary glaucoma. Blebs with a large avascular area were associated with a higher risk of bleb leakage. Attention to the increased chance of leakage induced by DOP is important, especially for blebs with a long postoperative duration. Ophthalmologists should be aware of late bleb-related complications in addition to bleb function.
Dr. C.Y. Hu, Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
