Volume of the filtering bleb in prediction of the effectiveness of glaucoma surgery: preliminary results
V. P. Erichev,
I. A. Novikov,
G. K. Khachatryan,
A. S. Makarova,
M. V. Budzinskaya,
A. O. Tarasenkov https://doi.org/10.53432/2078-4104-2024-23-4-3-10
Abstract
PURPOSE. To explore the potential for predicting the hypotensive effectiveness of glaucoma surgeries based on the parameters of the filtering bleb (FB) measured using optical coherence tomography (OCT).
METHODS. The study included 15 patients (15 eyes) with uncontrolled primary open-angle glaucoma, who underwent standard glaucoma surgery: sinus trabeculectomy with basal iridectomy. Objective assessment of the FB was performed using OCT on postoperative day 2, and then at 7 days, 1 month, and 3 months after surgery. Based on the OCT scans, a three-dimensional model of the FB was constructed, and its volume was calculated.
RESULTS. In 3 patients, by the end of the observation period, the FB volume was less than 5.7 mm³, which was associated with an unsuccessful surgical outcome and an increase in intraocular pressure (IOP) to 22.1±3.2 mm Hg. These patients were prescribed hypotensive therapy to achieve target IOP levels. In the other 12 patients, the IOP remained below 14 mm Hg throughout the observation period, with an average IOP of 11.7±2.3 mm Hg. The FB in these patients was diffuse, and its volume exceeded 5.7 mm³. The successful outcome of the surgery allowed for these patients to avoid the need for additional hypotensive therapy.
CONCLUSION. Long-term success of glaucoma surgery can be predicted using the threshold filtering bleb volume of 5.7 mm³.
About the Authors
V. P. Erichev
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor
11A Rossolimo St., Moscow, 119021
I. A. Novikov
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
Senior Researcher at the Laboratory of Fundamental Research in Ophthalmology
11A Rossolimo St., Moscow, 119021
G. K. Khachatryan
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
Cand. Sci. (Med.), Researcher at the Department of Glaucoma
11A Rossolimo St., Moscow, 119021
A. S. Makarova
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
Cand. Sci. (Med.), Senior Researcher at the Department of Glaucoma
11A Rossolimo St., Moscow, 119021
M. V. Budzinskaya
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
Dr. Sci. (Med.), Chief Researcher at the Department of Retinal and Optic Nerve Pathology, Professor at the Academic Department of Ophthalmology
11A Rossolimo St., Moscow, 119021
A. O. Tarasenkov
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
ophthalmologist
11A Rossolimo St., Moscow, 119021
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For citations:
Erichev V.P., Novikov I.A., Khachatryan G.K., Makarova A.S., Budzinskaya M.V., Tarasenkov A.O. Volume of the filtering bleb in prediction of the effectiveness of glaucoma surgery: preliminary results. National Journal glaucoma. 2024;23(4):3-10. (In Russ.) https://doi.org/10.53432/2078-4104-2024-23-4-3-10
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