Abstract
Introduction To examine the corneal total higher-order aberrations before and after the excision of an overhanging bleb that developed following trabeculectomy. Case Presentation. Two patients who developed overhanging blebs following trabeculectomy with a fornix-based conjunctival flap using mitomycin C (MMC) were assessed. We measured the corneal total higher-order aberrations for a 4 mm pupil diameter using the TOPCON KR-1W wavefront analyzer and the visual acuity before and after bleb excision. The corneal total higher-order aberration (HOA) improved from 0.50 μm to 0.38 μm in case 1 and from 0.59 μm to 0.49 μm in case 2 after bleb excision. The intraocular pressure was identical before and after bleb excision in both cases. No significant changes in the best-corrected visual acuity (BCVA) were noted in case 1; however, BCVA was improved from 20/25 to 20/20 in case 2. Both cases showed improvements in the symptoms of dysesthesia. Conclusion Excision of the overhanging bleb developed following trabeculectomy may have beneficial possibility in some cases where corneal total HOA is affected and reduces the symptoms of dysesthesia.
Highlights
To examine the corneal total higher-order aberrations before and after the excision of an overhanging bleb that developed following trabeculectomy
Glaucoma is an optic neuropathy characterized by gradual progressive morphological changes in the optic disc that leads to visual field loss [1]
Trabeculectomy is an effective surgery that is performed for lowering the intraocular pressure (IOP) in patients with glaucoma to hinder the progression of visual field loss
Summary
Glaucoma is an optic neuropathy characterized by gradual progressive morphological changes in the optic disc that leads to visual field loss [1]. Trabeculectomy is an effective surgery that is performed for lowering the intraocular pressure (IOP) in patients with glaucoma to hinder the progression of visual field loss. Following this surgery, patients occasionally complain of foreign body sensation, poor cosmetic appearance, and reduction in vision. Several studies have shown that trabeculectomy results in changes in the corneal keratometry, astigmatism, and topography, which lead to change in vision [2, 3] In such patients, some have overhanging blebs (OHBs), which are defined as oversized filtering blebs that cover part of the cornea. We examined the optical characteristics before and after excision of OHBs by a wavefront analyzer, which can objectively simulate the retinal image of Landolt C using its simulation system for the first time
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