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In vivo confocal microscopy evaluation of morpho-functional correlations of filtering bleb in glaucomatous patients

Poster Details

First Author: S.Bagaglia ITALY

Co Author(s):    P. Mittica   C. Menicacci   E. Paladini   F. Toto   E. Motolese   P. Frezzotti

Abstract Details


Efficacy and long-term success of filtering bleeb after trabeculectomy depends on the postoperative development of a functioning filtering bleb. This stud was made to observe histological changes in filtering blebs after trabeculectomy using in vivo confocal microscopy (IVCM), and to investigate the correlation between morphology and function of filtering blebs.


Department of Neurosciences, U.O.C. of Ophthalmology, University of Siena, Italy


40 glaucomatous eyes that had received trabeculectomy underwent slit-lamp examination,Goldmann applanation tonometry, and in vivo confocal microscopy follow up in 24 months. Eyes were classified into 4 groups according to the morphologic appearance of the filtering bleb based on the Kronfled system: type I blebs (7 eyes), type II blebs (14 eyes), type III blebs (13 eyes), and type IV blebs (6 eyes). The IVCM images were analyzed for the number of intraepithelial microcysts and density and fibrosis of subepithelial connective tissue.


Type II blebs presented with numerous intraepithelial vacuolar microcysts, while several large intraepithelial microcysts were found intype I blebs. Subepithelial connective tissue was widely spaced in type I and II blebs. Less spaced in type III and IV, In contrast, type III and IV blebs showed few or no intraepithelial microcysts, and subepithelial connective tissue was densely distributed.


IVCM is an usefull instrument to evaluate filtering bleeb function. Different types of blebs reveal various histological characteristics at the cellular level, which appear to be correlated with postoperative filtering function after 24 months. FINANCIAL INTEREST: NONE

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