Bleb morphology after trabeculectomy: A comparison of the Indiana Bleb Appearance Grading Scale and three-dimensional anterior segment optical coherence tomography.
Ahmadzadeh Afrouz, Narita Akiko, Simmendefeldt Schmidt Bo, Sugihara Kae, Kessel Line, Miyake Tomoe, Bach-Holm Daniella
AI Summary
This study compared bleb assessment methods, finding the visual IBAGS scale correlated better with IOP than AS-OCT. This suggests IBAGS is more relevant for predicting trabeculectomy success and guiding glaucoma management.
Abstract
Purpose
To compare bleb morphology after trabeculectomy using a visual grading system, the Indiana Bleb Appearance Grading Scale (IBAGS) and anterior segment optical coherence tomography (AS-OCT).
Methods
Fifty-seven patients who underwent trabeculectomy were included in this study. Clinical evaluations of the bleb and imaging with anterior segment OCT were conducted 12 months postoperatively. Bleb assessments were performed using a slit-lamp microscope with the IBAGS and a 3D AS-OCT CASIA2.
Results
Bleb height evaluations from IBAGS and AS-OCT measurements showed a moderate positive correlation (p = 0.03), indicating alignment between the two systems. IBAGS variables explained about 16% of the variance in IOP, with a significant negative relationship between bleb height and IOP (for each unit increase in bleb height, IOP decreased by 1.9 mmHg; p = 0.03). The overall model fit was significant for IBAGS (p = 0.03) but not for AS-OCT (p = 0.2), suggesting that IBAGS may be more relevant for predicting IOP.
Conclusion
IBAGS demonstrated a stronger association with IOP, suggesting its greater relevance in assessing trabeculectomy bleb morphology for predicting surgical success. Additionally, we found a significant correlation between bleb height measurements obtained from IBAGS and the AS-OCT system. By integrating both systems, a more comprehensive approach to monitoring bleb function can be achieved, ultimately improving the accuracy of postoperative glaucoma management.
Shields Classification
Key Concepts4
Bleb height evaluations from the Indiana Bleb Appearance Grading Scale (IBAGS) and anterior segment optical coherence tomography (AS-OCT) measurements showed a moderate positive correlation (p = 0.03) in 57 patients who underwent trabeculectomy, indicating alignment between the two systems.
Indiana Bleb Appearance Grading Scale (IBAGS) variables explained about 16% of the variance in intraocular pressure (IOP) in 57 patients who underwent trabeculectomy, with a significant negative relationship between bleb height and IOP (for each unit increase in bleb height, IOP decreased by 1.9 mmHg; p = 0.03).
The overall model fit for predicting intraocular pressure (IOP) was significant for the Indiana Bleb Appearance Grading Scale (IBAGS) (p = 0.03) but not for anterior segment optical coherence tomography (AS-OCT) (p = 0.2) in 57 patients who underwent trabeculectomy, suggesting that IBAGS may be more relevant for predicting IOP.
The Indiana Bleb Appearance Grading Scale (IBAGS) demonstrated a stronger association with intraocular pressure (IOP) compared to anterior segment optical coherence tomography (AS-OCT) in assessing trabeculectomy bleb morphology for predicting surgical success in 57 patients.
Related Articles5
Ahmed's sub-flap mattress suture deep sclerectomy assessment with Ultrasound Biomicroscopy.
Randomized Controlled TrialMulti-Quantitative Assessment of AS-OCTA Complemented AS-OCT for Monitoring Filtering Bleb Function After Trabeculectomy.
Observational StudyRelationship between filtering bleb vascularization and surgical outcomes after trabeculectomy: an optical coherence tomography angiography study.
Prospective StudySupraciliochoroidal fluid in the eyes indicates good intraocular pressure control despite absence of obvious filtering bleb after trabeculectomy.
Case SeriesUltrasound biomicroscopy and intraocular-pressure-lowering mechanisms of deep sclerectomy with reticulated hyaluronic acid implant.
Clinical TrialIs this article assigned to the wrong chapter(s)? Let us know.