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Early postop bleb morphology may predict trabeculectomy success

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After trabeculectomy, the early postoperative appearance of filtering blebs may help identify patients who are at increased risk of bleb failure, a recent study indicates.

Stefan Sacu, MD, and colleagues at the University of Vienna (Austria) Medical School, conducted a prospective study correlating the morphologic appearance of filtering blebs up to 2 weeks postop with overall outcomes at 1 year follow-up.

In the study, 49 eyes of 49 patients underwent primary trabeculectomy with adjunctive use of mitomycin-C. All patients had intraocular pressure readings of 21 mm Hg or less at 1 year follow-up, with six patients using antiglaucoma medications. One eye required needling due to bleb encapsulation.

Eyes that developed conjunctival subepithelial microcysts by 2 weeks postop had significantly lower mean IOPs (11.1 mm Hg) at the 1 year mark than eyes without microcysts (13.9 mm Hg).

Eyes that developed corkscrew vessels by 2 weeks follow-up had significantly higher mean IOPs over the full year (13.4 mm Hg) compared to eyes without (11.7 mm Hg).

The study is published in the Journal of Glaucoma.