Ultrasound biomicroscopy and optical coherence tomography imaging of filtering blebs after deep sclerectomy with new collagen implant

作者：Aptel Florent^*; Dumas Sophie; Denis Philippe

来源：European Journal of Ophthalmology, 2009, 19(2): 223-230.

DOI：10.1177/112067210901900208

• Ologen
• Ultrasound biomicroscopy
• Optical coherence tomography
• Filtering blebs
• Deep sclerectomy

PURPOSE. To identify the clinical and anatomic characteristics of filtering blebs after glaucoma surgery with a new biodegradable collagen implant, Ologen, using ultrasound biomicroscopy (UBM) and Visante anterior segment optical coherence tomography (OCT).
METHODS. The authors conducted a prospective interventional case series in 15 eyes with open-angle glaucoma. The authors performed limbal-based deep sclerectomy with Ologen implantation in the scleral bed. UBM, Visante anterior segment OCT, and a complete ophthalmic examination were performed at each follow-up visit, at 1 day, and 1, 4, and 12 weeks postoperatively.
RESULTS. Intraocular pressure (IOP) was significantly reduced (p<0.001) from a mean preoperative value of 24.2 /- 6.8 mmHg (n=2.82 glaucoma medications) to a mean postoperative value of 8.1 /- 1.2 (n=0), 8.5 /- 1.3 (n=0), 11.7 /- 3.2 (n=0), and 14.2 /- 3.9 mmHg (n=0.33) at 1 day, and 1, 4, and 12 weeks, respectively. Lower IOP correlated with bleb height and low trabeculocorneal membrane thickness (r=0.79, p<0.01, r=0.91, p<0.001) based on UBM examination. Lower IOP correlated with thin bleb wall, large subconjunctival fluid spaces, and low bleb tissue reflectivity (r=0.81, p<0.01, p<0.001, and p<0.001) based on OCT examination. No postoperative complications were reported.
CONCLUSIONS. UBM and OCT examinations are useful methods to evaluate outflow mechanisms after glaucoma surgery. Deep sclerectomy with Ologen implantation seems to be an effective and well-tolerated method to reduce IOP. (Eur J Ophthalmol 2009; 19: 223-30)

• 出版日期2009-4