Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
J Healthc Eng. 2018 May 15;2018:5909827. doi: 10.1155/2018/5909827. eCollection 2018.
We combined a clinical grading scale and swept source anterior segment OCT to describe the successful and failed CLASS.
23 patients in the successful group and 17 patients in the failed group were compared in terms of the IBAGS grades and AS-OCT findings at one, three, and twelve months postoperatively.
The majority in the successful group presented shallow blebs (91%, 57%, and 52% at 1M, 3M, and 12M, resp.). 59% of the failed group presented no bleb (H0 E0) from the early postoperative period with the rate increasing to 88% at 3M and 100% at 12M. The scleral lake was detected in all the successful patients. The successful group showed significantly higher rates of TDM integrity ( < 0.001), IF ( < 0.001), and SCF ( < 0.05), but there were no significant differences in the rates of microcysts between the groups ( > 0.05). We found a significant decrease in the SL anteroposterior extent (=0.003) and SL height ( < 0.001) over time, with no significant correlation between the above parameters and IOP.
The subconjunctival bleb may be a sign of the successful CLASS when it matches the AS-OCT findings of TDM integrity, maintained scleral lake, and intrascleral fluid. A validated OCT pixel intensity measurement is required to evaluate the bleb reflectivity.
我们结合临床分级量表和扫频源眼前节 OCT 来描述 CLASS 的成功和失败。
在术后 1、3、12 个月,我们比较了成功组的 23 例患者和失败组的 17 例患者的 IBAGS 分级和 AS-OCT 发现。
成功组的大多数患者表现为浅前房(术后 1、3、12 个月分别为 91%、57%和 52%)。失败组的 59%患者从术后早期开始没有前房(H0 E0),这一比例在 3 个月时增加到 88%,在 12 个月时增加到 100%。所有成功患者均检测到巩膜湖。成功组的 TDM 完整性(<0.001)、IF(<0.001)和 SCF(<0.05)的比例明显较高,但两组间微囊的比例无明显差异(>0.05)。我们发现 SL 前后径(=0.003)和 SL 高度(<0.001)随时间显著下降,但上述参数与眼压无显著相关性。
当结膜下滤过泡与 TDM 完整性、维持的巩膜湖和巩膜下积液的 AS-OCT 发现相匹配时,可能是 CLASS 成功的标志。需要验证 OCT 像素强度测量来评估滤过泡的反射率。