Association bleb morphology features and intraocular pressure following trabeculectomy in primary glaucoma

Masitha Dewi Sari.,Faisal Bustami and Aslim D. Sihotang

Background: Glaucoma is the second leading cause of blindness in the world. Trabeculectomyis indicated for eye with primary glaucoma that have an inadequate IOP with maximum tolerated medical therapy. The success of this surgery depends on the functionality of the filtering bleb, aqueous humor drainage and IOP lowering effect.

Methods: A serial prospective analytic case study, we analysed 21 eyes (19 patients) primary glaucoma patients who underwent trabeculectomy. Blebmorphology grading was scored according to Moorfields Bleb Grading System Scale and intraocular pressure was measured bynon contact tonometry. The IOP and bleb morphology was assessed before surgery and on day 1st, 7th, 14th and 30th post operative.

Results : Blebs of 21 eyes were assessed until 1 month. All subjects had IOP< 21 mmHg on the 1st, 7th, 14th, 30th day although 1 subjects reached IOP >21 mmHg on the 30 day. There was tendency of increasing mean IOP but still normal meanwhile all variable of morphology bleb had decreasing gradation in average. There was only significantly associated in the first day after trabeculectomy in central bleb area with IOP (p<0,05) but in other variables there was no significantly differences (p>0,05).

Conclusion: The gradation of each variable bleb morphology had decreased and IOP tended to normal postoperatively according to follow up time but from statistical analysis there was not strongly correlated between each variable bleb morphology with IOP.

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