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In vivo confocal microscopy evaluation of morpho-functional correlation and surgical outcome of filtering blebs in glaucoma patients: 1 year follow-up

Poster Details

First Author: S.Bagaglia ITALY

Co Author(s):    M. Vergine   P. Frezzotti                 

Abstract Details

Purpose:

to evaluate morpho-functional correlation between conjunctival epithelial cells (EC), goblet cells (GC), micro-cysts density (MCD), by in vivo confocal microscopy (IVCM), and surgical outcome in patients with uncontrolled glaucoma treated by mitomycin-C augmented trabeculectomy.

Setting:

University of Siena, Department Of Ophthalmology

Methods:

Case control study including 42 eyes of 38 patients, mean age 74,4 years �Â�±9,2 with medical therapy uncontrolled glaucoma. Inclusion criteria where primary open angle glaucoma (POAG) pseudoexfoliative glaucoma (PEX) and pigmentary glaucoma. Uncontrolled glaucoma was assessed by >20 mmHg intraocular pressure; glaucoma progression was confirmed by at least 3 consecutive SITA 30.2 STD Visual field examinations (Humphrey Field Analyzer II 750 Carl Zeiss, USA). All ocular surgeries except for selective laser trabeculoplasty or cataract surgery within 1 year where considered exclusion criteria. IVCM (Heidelberg HRT II -Rostock Cornea module), scans were performed before surgery, at 3-6 and 12 months.

Results:

Trabeculectomy showed a statistically significant reduction of average intraocular pressure form 22,7mmHg to 15,3 mmHg (P<0,0001), such as an increase of the average number of GC from 60,5 to 90 at 12 months (P<0,0001), contrarily EC showed no statistically significant variations (P 0,43). MC density showed statistically significant increase after 3 months, reaming stable at 12 months (P<0,0001).

Conclusions:

Trabeculectomy successfully reduces IOP and increase conjunctival MC density and GC number especially in fully successful blebs where was shown a higher number of preoperative conjunctival GC.

Financial Disclosure:

NONE

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