Moon Sangwoo, Lee Seungmin, Lee Jiwoong
Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan 50612, Republic of Korea.
Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan 49241, Republic of Korea.
J Clin Med. 2025 Aug 5;14(15):5499. doi: 10.3390/jcm14155499.
: This study aimed to evaluate prognostic factors of early filtering blebs using anterior segment swept-source optical coherence tomography (AS SS-OCT) in patients with uveitic and neovascular glaucoma. : This retrospective cohort study included 22 eyes from 22 patients who underwent trabeculectomy (11 eyes each with uveitic or neovascular glaucoma). Intrableb characteristics were assessed using AS SS-OCT at 1 month, postoperatively. Surgical success was defined as intraocular pressure (IOP) ≤ 18 mmHg and ≥30% IOP reduction without medication at 12 months. Logistic regression was used to identify the prognostic factors associated with IOP control. : Sixteen eyes (72.7%) achieved surgical success, while six (27.3%) were unsuccessful. Eyes with successful IOP control at 12 months showed thicker and less reflective bleb walls with microcysts compared with unsuccessful cases of IOP control, in the early postoperative phase (all < 0.033). However, IOP at the time of OCT did not significantly differ between the groups ( = 0.083). Multivariate logistic regression analysis revealed that higher bleb wall reflectivity at 1-month post-trabeculectomy was significantly associated with a higher surgical failure rate at 12 months after trabeculectomy (hazard ratio = 1.072, = 0.032). : Early intrableb assessment using AS SS-OCT may be beneficial for managing filtering blebs after trabeculectomy in uveitic and neovascular glaucoma. Higher bleb wall reflectivity in the early post-trabeculectomy phase may indicate poor features of the filtering bleb, suggesting the need for timely interventions for refractory cases.
本研究旨在利用眼前节扫频光学相干断层扫描（AS SS-OCT）评估葡萄膜炎性和新生血管性青光眼患者早期滤过泡的预后因素。本回顾性队列研究纳入了22例接受小梁切除术的患者的22只眼（葡萄膜炎性或新生血管性青光眼各11只眼）。术后1个月使用AS SS-OCT评估滤过泡内特征。手术成功定义为12个月时眼压（IOP）≤18 mmHg且无需药物治疗眼压降低≥30%。采用逻辑回归分析确定与眼压控制相关的预后因素。16只眼（72.7%）手术成功，6只眼（27.3%）手术失败。与眼压控制失败的病例相比，术后早期眼压控制成功的眼在术后早期显示滤过泡壁更厚、反射性更低且有微囊肿（均P<0.033）。然而，两组间OCT检查时的眼压无显著差异（P=0.083）。多因素逻辑回归分析显示，小梁切除术后1个月滤过泡壁反射性较高与小梁切除术后12个月手术失败率较高显著相关（风险比=1.072，P=0.032）。利用AS SS-OCT进行早期滤过泡内评估可能有助于葡萄膜炎性和新生血管性青光眼小梁切除术后滤过泡的管理。小梁切除术后早期滤过泡壁反射性较高可能提示滤过泡特征不佳，提示难治性病例需要及时干预。
