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Comparison of conjunctival vascularity changes using optical coherence tomography angiography after trabeculectomy and phacotrabeculectomy
Author(s) -
Hyun Seo Je
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.5034
Subject(s) - trabeculectomy , medicine , vascularity , glaucoma , bleb (medicine) , intraocular pressure , ophthalmology , optical coherence tomography , surgery , glaucoma surgery
Purpose To compare the bleb vascularity using optical coherence tomography angiography (OCT‐A) between mitomycin‐C (MMC) augmented trabeculectomy and phacotrabeculectomy and to investigate the relationship between bleb vascularity and surgical outcomes. Methods We retrospectively reviewed data for 72 eyes from 72 glaucoma patients who underwent MMC augmented trabeculectomy with/without cataract surgery. Bleb area scans were obtained using OCT‐A during the preoperative period and 1, 2, 4, and 6 weeks, and 2, 4, and 6 months postoperatively. For conjunctival vascularity analysis, a semi‐automated program was used to calculate the densities of color and brightness of the selected area. Results Color and brightness densities were decreased in the trabeculectomy group during all periods, whereas it did not decrease in the phacotrabeculectomy group at 4 and 6 weeks, 2, 4, and 6 months. The color and brightness densities were significantly higher in the phacotrabeculectomy group than in the trabeculectomy group after 6 weeks and 2, 4, and 6 months. A Kaplan‐Meier survival graph showed that the intraocular pressure was not different according to surgery type, but glaucoma type. Logistic regression analysis revealed that the brightness density 1 week postoperation was correlated with reoperation. Conclusions Following trabeculectomy with MMC, The brightness density one week postoperation may be a predictive index for surgical outcomes, suggesting that a more accurate prediction could be made if evaluation of bleb structural analysis and bleb vascularity are performed simultaneously.