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Confocal microscopy of filtering blebs post anti-glaucoma surgery using HRT III cornea module

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Session Details

Session Title: Imaging Anterior Segment

Session Date/Time: Sunday 08/10/2017 | 16:00-18:00

Paper Time: 16:00

Venue: Meeting Center Room I

First Author: : S.Ganatra INDIA

Co Author(s): :    M. Patel   M. Mansuri                 

Abstract Details


The aim of this short term prospective nonrandomized clinical study is to analyze filtering blebs after trabeculectomy by means of in vivo confocal microscopy.


M & J Western Regional Institute Of Ophthalmology , Ahmedabad , India


Seventy three in vivo confocal examinations were performed in 73 filtering blebs in 62 patients, who underwent trabeculectomy surgery by fornix based route either with or without use of Mitomycin C. Confocal Microscopy was done 6 weeks and 6 months post operatively. Only the final examination of each bleb was considered for statistical analysis. Confocal microscopy of the blebs was done by the Heidelberg Retina Tomograph III in association with the Rostock Cornea Module (Heidelberg Engineering, Heidelberg, Germany).


At examination, target pressure was reached in 69 eyes without antiglaucoma medication. In 4 eyes, target pressure was not achieved.In vivo confocal microscopy demonstrated encapsulated epithelial microcysts in 95.90% of filtering blebs. Grade 1 vascularization was stroma was seen in 95.89% cases and condensed stroma in 4.11% cases. A condensed, hyperreflective bleb stroma was typically associated with bleb failure. Blurred stroma: Blurred stroma was typically present in the first 2 postoperative months and was mainly associated with a loose collagen like meshwork.


In vivo confocal microscopy is useful in cases where slit lamp examination of bleb and intraocular pressure does not correlate. Confocal microscopy of the filtering blebs assesses functionality of the blebs with the added advantage of early detection than by slit lamp. Blebs having loose collagenous stroma benefit from bleb needling. Blebs having condensed stroma are failed blebs and thus repeat trabeculectomy is warranted. This helps in early detection of failing blebs and helps the surgeon to take necessary corrective measures.

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