Abstract
Purpose
To investigate the effects of laser suture lysis (LSL) on filtration openings after trabeculectomy.
Methods
Prospective study analyzing the changes in the location and width of filtration openings, fluid cavity height, total bleb height, bleb wall thickness, and bleb wall intensity before and after LSL using three-dimensional anterior segment optical coherence tomography (3D AS-OCT).
Results
Fourteen patients had clear scleral flap image analysis. As five patients underwent LSL twice and two patients underwent LSL thrice, 23 comparison studies were possible. After LSL the intraocular pressure (IOP) decreased (P=0.0015) from 20.5±5.3 to 14.9±6.4 mm Hg, and the fluid cavity height increased significantly from 0.2±0.2 mm to 0.3±0.1 mm (P=0.0094). Other bleb parameters were not significantly different when comparing before and after LSL. When the IOP reduction ratio was >25% following LSL, the width of the filtration openings on the LSL side, the total bleb height, and the fluid cavity height increased (P=0.0273, 0.0342, and 0.0024, respectively). In multiple regression analysis the changes in fluid cavity height, the wall thickness, the wall intensity, and the width of the filtration opening were positively associated with the IOP reduction rate (P=0.0428, 0.0226, 0.0420, and 0.0356, respectively).
Conclusions
3D AS-OCT allowed a detailed examination of the internal morphology of filtration blebs and openings before and after LSL. The changes in the internal morphology were closely associated with the success of LSL to decrease IOP.
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Acknowledgements
This study was approved by the Institutional Review Board of Kumamoto University (Kumamoto, Japan), and was registered with the University Hospital Medical Information Network Clinical Trials Registry of Japan (ID UMIN000006008; date of access and registration, 21 July 2011).
Author contributions
H-kC, TI, and HT conducted the study design; H-kC, TI, and HT performed the study; H-kC, TI, AF, and SK collected the data, management, analysis, and interpretation; and H-kC, TI, CK, and HT were involved in the preparation, review, and approval of the manuscript.
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Cho, Hk., Kojima, S., Inoue, T. et al. Effect of laser suture lysis on filtration openings: a prospective three-dimensional anterior segment optical coherence tomography study. Eye 29, 1220–1225 (2015). https://doi.org/10.1038/eye.2015.129
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DOI: https://doi.org/10.1038/eye.2015.129
