{"title":"Distinctive intrableb structures of functioning blebs following trabeculectomy according to amniotic membrane transplantation.","authors":"Sangwoo Moon, Jiwoong Lee","doi":"10.1159/000542762","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Intrableb structures are hallmark features of the filtering bleb. This study aimed to compare the characteristics of functioning blebs using anterior segment optical coherence tomography (AS-OCT) according to amniotic membrane transplantation (AMT).</p><p><strong>Methods: </strong>Forty eyes from 40 patients diagnosed with primary open-angle glaucoma who underwent trabeculectomy, either with AMT (20 eyes) or without AMT (control group, 20 eyes), were included. Parameters including bleb height, bleb wall thickness, striping layer thickness, striping to bleb wall ratio, bleb wall reflectivity, fluid-filled space score/height/area, and presence of microcysts were assessed using AS-OCT. Surgical success was defined at the time of AS-OCT as an IOP ≤18 mmHg and IOP reduction ≥30% without medication. In these patients, if the bleb had a clinically diffuse and healthy without any signs of an encapsulated bleb, the bleb was then defined as functioning bleb.</p><p><strong>Results: </strong>Except for bleb height (P = 0.352) and microcyst formation (P = 0.266), significant differences were observed between the two groups. The functioning blebs of the AMT group exhibited greater fluid-filled space score, area, and height than those of the control group, following adjustment for AS-OCT time (all P < 0.001). Conversely, the functioning bleb of the control group demonstrated thicker bleb wall and striping layer, higher striping to bleb wall ratio, and lower bleb wall reflectivity than those of the AMT group, following adjustment for AS-OCT time (all P ≤ 0.001).</p><p><strong>Conclusion: </strong>Distinct intrableb structures were identified in functioning blebs according to amniotic membrane transplantation. The reflectivity and thickness of the bleb wall structures were more pronounced in the functioning bleb after trabeculectomy alone. In contrast, the extent of the fluid-filled space emerged as a more distinctive feature of the intrableb structures in the functioning bleb after trabeculectomy with AMT.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.0000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000542762","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
简介内出血结构是滤过性眼泡的标志性特征。本研究旨在根据羊膜移植术(AMT)使用前节光学相干断层扫描(AS-OCT)比较功能性滤过泡的特征:方法:40 名原发性开角型青光眼患者的 40 只眼睛接受了小梁切除术,其中 20 只眼睛接受了羊膜移植术(AMT),20 只眼睛未接受羊膜移植术(对照组,20 只眼睛)。使用 AS-OCT 评估的参数包括眼泡高度、眼泡壁厚度、剥离层厚度、剥离层与眼泡壁比率、眼泡壁反射率、充液空间评分/高度/面积以及是否存在微囊。在进行 AS-OCT 检查时,手术成功的定义是:眼压≤18 mmHg,且在不用药的情况下眼压降低≥30%。在这些患者中,如果眼泡在临床上弥漫且健康,没有任何包裹眼泡的迹象,则该眼泡被定义为功能性眼泡:除了血泡高度(P = 0.352)和微囊形成(P = 0.266)外,两组之间观察到显著差异。在对 AS-OCT 时间进行调整后,AMT 组的功能性眼泡在充液空间得分、面积和高度方面均高于对照组(所有 P <0.001)。相反,经 AS-OCT 时间调整后,对照组的功能性虹膜比 AMT 组的虹膜壁和条纹层更厚、条纹与虹膜壁比率更高、虹膜壁反射率更低(所有 P 均小于 0.001):结论:根据羊膜移植的不同,在功能性虹膜中发现了不同的虹膜内结构。结论:根据羊膜移植的情况,在功能正常的出血窦中发现了明显的出血窦内结构,仅在小梁切除术后,出血窦壁结构的反射率和厚度更加明显。相比之下,在小梁切除术和羊膜移植术后的功能性眼泡中,充液空间的范围成为眼泡内结构的更显著特征。
Distinctive intrableb structures of functioning blebs following trabeculectomy according to amniotic membrane transplantation.
Introduction: Intrableb structures are hallmark features of the filtering bleb. This study aimed to compare the characteristics of functioning blebs using anterior segment optical coherence tomography (AS-OCT) according to amniotic membrane transplantation (AMT).
Methods: Forty eyes from 40 patients diagnosed with primary open-angle glaucoma who underwent trabeculectomy, either with AMT (20 eyes) or without AMT (control group, 20 eyes), were included. Parameters including bleb height, bleb wall thickness, striping layer thickness, striping to bleb wall ratio, bleb wall reflectivity, fluid-filled space score/height/area, and presence of microcysts were assessed using AS-OCT. Surgical success was defined at the time of AS-OCT as an IOP ≤18 mmHg and IOP reduction ≥30% without medication. In these patients, if the bleb had a clinically diffuse and healthy without any signs of an encapsulated bleb, the bleb was then defined as functioning bleb.
Results: Except for bleb height (P = 0.352) and microcyst formation (P = 0.266), significant differences were observed between the two groups. The functioning blebs of the AMT group exhibited greater fluid-filled space score, area, and height than those of the control group, following adjustment for AS-OCT time (all P < 0.001). Conversely, the functioning bleb of the control group demonstrated thicker bleb wall and striping layer, higher striping to bleb wall ratio, and lower bleb wall reflectivity than those of the AMT group, following adjustment for AS-OCT time (all P ≤ 0.001).
Conclusion: Distinct intrableb structures were identified in functioning blebs according to amniotic membrane transplantation. The reflectivity and thickness of the bleb wall structures were more pronounced in the functioning bleb after trabeculectomy alone. In contrast, the extent of the fluid-filled space emerged as a more distinctive feature of the intrableb structures in the functioning bleb after trabeculectomy with AMT.
期刊介绍:
''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.