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The following is a summary of “Sonographic bleb visualisation after PAUL glaucoma implant surgery,” published in the December 2024 issue of Ophthalmology by Weber et al.
Evaluation of bleb characteristics following glaucoma drainage device (GDD) surgery using slit lamp examination was challenging, leading to the exploration of ultrasound sonography for more detailed visualization.
Researchers conducted a retrospective study to describe bleb configuration after PAUL glaucoma implant (PGI) surgery and evaluate its potential correlation with intraocular pressure (IOP) to identify new markers for assessing GDD function.
They performed a 15 MHz ultrasound examination (Compact Touch, Quantel Medical) on patients after PGI surgery. The dimensions of the filtering bleb were measured, and the bleb configuration was assessed, along with the documentation of all relevant clinical data.
The results showed that 70 eyes from 65 patients were included, with 55 eyes (78.6%) having a double-layered bleb and 15 eyes (21.4%) having a single-compartment bleb (6 eyes, 8.6% above; 9 eyes, 12.9% below the plate). The average total height of both compartments was 3.52 mm, and the mean IOP was 13.03 mm Hg. A significant correlation was found between IOP and bleb configuration (1 compartment: 16.47 mm Hg vs 2 compartments: 12.09 mm Hg, P <0.01). No significant correlation was observed with bleb height (P =0.143) or extension (T: P =0.629; L: P =0.742). However, higher bleb height (>2 mm) was associated with significantly lower IOP compared to smaller blebs (P =0.041).
Investigators concluded the sonography effectively evaluated bleb characteristics after GDD implantation, with double-layered blebs and higher bleb heights (>2 mm) significantly associated with lower IOP.
Source: bjo.bmj.com/content/early/2024/12/15/bjo-2024-326168
