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The following is a summary of “Distinctive intrableb structures of functioning blebs following trabeculectomy according to amniotic membrane transplantation,” published in the November 2024 issue of Ophthalmology by Moon and Lee. 

Researchers conducted a retrospective study to compare the characteristics of functioning blebs using anterior segment optical coherence tomography (AS-OCT) in relation to amniotic membrane transplantation (AMT).  

They included 40 patients’ eyes diagnosed with primary open-angle glaucoma who underwent trabeculectomy, with 20 eyes receiving AMT and 20 eyes in the control group. Using AS-OCT, the parameters such as bleb height, wall thickness, striping layer thickness, striping to bleb wall ratio, reflectivity, fluid-filled space score/height/area, and the presence of microcysts were assessed. Surgical success was portrayed as an IOP ≤18 mmHg and IOP reduction ≥30% without medication at the time of AS-OCT. Functioning blebs were defined as clinically diffuse and healthy with no signs of encapsulation.  

The results showed that, except for bleb height (P = 0.352) and microcyst formation (P = 0.266), significant differences were found between the 2 groups. The functioning blebs in the AMT group had significantly greater fluid-filled space score, area, and height compared to the control group after adjusting for AS-OCT time (all P < 0.001). In contrast, the functioning blebs in the control group exhibited thicker bleb walls and striping layers, a higher striping to bleb wall ratio, and lower bleb wall reflectivity than the AMT group after adjusting for AS-OCT time (all P ≤ 0.001).  

Investigators concluded that distinct intrableb structures were identified in functioning blebs, with differences in reflectivity, thickness, and fluid-filled space between blebs formed with and without AMT. 

Source: karger.com/ore/article/doi/10.1159/000542762/916603/Distinctive-intrableb-structures-of-functioning