Qualitative analysis of repaired filtering blebs with anterior segment-optical coherence tomography

Abstract

Abstract Objective To provide a qualitative analysis of filtering blebs after being surgically repaired due to late blebs leaks. Methods Blebs were studied 6 months after surgical reparation using AS-OCT Triton (Topcon ® ). An analysis was made of the morphological pattern and internal structures of blebs, including the covering, in 10 patients. The images were obtained using OCTs at a wavelength of 1050 nm. Results According to the Hirooka classification, three different patterns were found in the structure of blebs, which made it possible to correlate them with their functionality. A full covering was observed in 70% of the cases, and they showed sub-epithelial cysts (cystoid pattern). Two cases showed a full conjunctival retraction without Tenon's covering. The walls were thin, with a de-structured bleb (diffuse pattern) being visualized. In the third group, the image showed a partial conjunctival retraction with Tenon's covering. There were some sub-epithelial diffuse cysts with walls following a laminar pattern. Conclusion Using AS-OCT, it is possible to study the bleb's characteristics in detail, as well as the cover, in the case of blebs requiring repair due to late leaks, using conjunctival advancement. It allows for the early visualization of conjunctival retractions that were not visible in a slit lamp, and to predict the functionality of the blebs by their morphology.