ArticleBMC ophthalmology2025
Discriminatory power of trabeculectomy bleb internal reflectivity and morphology in surgical success using anterior segment optical coherence tomography.
Article in BMC ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Anterior Segment Optical Coherence Tomography and Anterior Segment Optical Coherence Tomography Angiography After Bleb Forming Glaucoma Surgeries: A Systematic Review.Clinical & experimental ophthalmology · 2025Pooled it
- Evaluation of Changes in Ocular Tissue Elasticity Before and After Trabeculectomy Using Shear Wave Elastography.Journal of clinical medicine · 2026Article
- Anterior Segment OCT Imaging of Bleb Morphological Changes as Predictors of Success After Bleb Needling.Turkish journal of ophthalmology · 2025Article
- Association Between Prior Selective Laser Trabeculoplasty and Phaco-iStent Inject Efficacy.Clinical & experimental ophthalmology · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe post-operative evaluation of trabeculectomy blebs has traditionally relied on subjective clinical grading systems performed at the slit-lamp. This study explores the use of swept source anterior-segment optical coherence tomography (AS-OCT) to objectively measure bleb internal reflectivity and morphology, and to distinguish blebs with surgical success vs. failure.
methodsCross-sectional study of patients with glaucoma who had undergone trabeculectomy at least one year prior. Swept source AS-OCT was used to capture filtering blebs in the sagittal plane. Standardised regions of interests on the sagittal plane were segmented, and pixel intensity values and bleb height were measured. Receiver operating characteristic curves were used to examine the discriminatory ability of pixel intensity values and bleb morphology to classify blebs with surgical success or failure.
results100 eyes of 65 patients were included, with a median post-operative follow up of 7.0 years (IQR 3.2-16 years). The proportion of complete success, qualified success and failure was 45%, 33%, and 22% respectively. The maximum bleb height was significantly greater in the blebs with complete success (1.74 vs. 1.25 vs. 1.23 mm in CS vs. QS vs. F, one-way ANOVA, p < 0.0001). Mean pixel intensity was significantly lower in blebs with complete success (150.8 vs. 157.4 vs. 167.4 in CS vs. QS vs. F, p = 0.0001). Bleb intensity standard deviation (AUC 0.81), maximal bleb height (AUC 0.76), mean pixel intensity (AUC 0.75) and minimum pixel intensity (AUC 0.75) offered the best discrimination between surgical success and failure.
conclusionsSwept-source AS-OCT can be used to quantify bleb internal reflectivity and morphology, which can be used to distinguish between well vs. poorly functioning blebs. These parameters may assist surgeons in the objective evaluation of post-operative bleb outcomes.
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