Use of trypan blue to assess lymphatic function following trabeculectomy.

IMPORTANCE

To illustrate the importance of lymphatic drainage in assessing trabeculectomy bleb function using intracameral trypan blue.

BACKGROUND

To study the lymphatic drainage of trabeculectomy blebs using trypan blue, correlate with bleb function and classify them accordingly.

DESIGN

Prospective cross-sectional study in a tertiary care centre.

PARTICIPANTS

Thirteen glaucoma patients post-trabeculectomy were studied.

METHODS

Trypan blue was injected into the anterior chamber.

MAIN OUTCOME MEASURES

The duration taken for dye to stain a drainage bleb or lymphatics is recorded. The extent of the lymphatic structures were measured in clock hours. Intraocular pressure (IOP) prior to surgery was recorded.

RESULTS

Eight post-trabeculectomy subjects with dye stained lymphatic vessels had lower IOP (12.6 mmHg, P = .013) compared to the five with no lymphatic vessel staining (mean IOP 23.6 mmHg). Lymphatic extent was inversely related to IOP (P = .021).

CONCLUSIONS AND RELEVANCE

Eyes with lymphatic connections to drainage blebs had lower IOP and reduced requirement for topical medications. The extent of lymphatic connection to drainage blebs is related to lower IOP.