Korean J Ophthalmol.  2023 Feb;37(1):53-61. 10.3341/kjo.2022.0082.

Filtering Bleb Size in the Early Postoperative Period Affects the Long-term Surgical Outcome after Trabeculectomy

• Jang YK
• Choi EJ
• Son DO
• Ahn BH
• Han JC

• KMID: 2539145
• DOI: http://doi.org/10.3341/kjo.2022.0082

Abstract

Purpose
To investigate whether postoperative filtering bleb size affects the surgical outcome after trabeculectomy.
Methods
In this study, we retrospectively reviewed 145 medically uncontrolled glaucoma patients with intraocular pressure (IOP) values >21 mmHg before surgery and data from ≥2 years of follow-up. Postoperative IOP, filtering bleb size including extent and height, and other clinical factors were measured after trabeculectomy. We divided bleb extent into quadrants and bleb height by 0.5 intervals of corneal thickness. The main outcome measure was surgical success. We confirmed complete success when the IOP was ≤21 mmHg and decreased by >20% from baseline without medication or additional procedures. Qualified success used the same criteria but allowed for medication or additional procedures. Cases with reoperation or two consecutive IOP measurements <6 mmHg were considered failures.
Results
A total of 145 eyes of 145 patients was included. The average observation period was 30.8 ± 10.9 months. During multivariate Cox regression analysis, a larger extent of filtering bleb revealed significantly low hazard ratios in both complete and surgical success (0.509 and 0.494, respectively); however, there was no significant relationship between bleb height and surgical outcome.
Conclusions
The extent of the filtering bleb was associated with surgical outcomes of trabeculectomy in glaucoma patients.

Keyword

Glaucoma; Intraocular pressure; Trabeculectomy