Anterior Segment
Conference Roundup

AS-OCT may provide objective quantification of bleb function following glaucoma surgery

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Researchers assessed the use of anterior-segment optical coherence tomography (AS-OCT) to evaluate bleb function in post-surgical eyes and found that this “objective” method may help guide pharmacologic treatment and early surgical intervention in these patients. The study was presented at the 2024 ARVO Annual Meeting in Seattle, Washington.

The cross-sectional study included 204 blebs of 120 patients who had undergone trabeculectomy (n=96) or deep sclerectomy (n=108) surgery at least 1 year prior for their glaucoma. Median postoperative follow-up was 8.4 years (interquartile range, 3.2-9.0).

Outcomes were measured as:

  1. Complete success (CS), defined as intraocular pressure (IOP) £18 mmHg without medication
  2. Qualified success (QS), defined as IOP £18 mmHg with medication
  3. Failure (F), defined as IOP >18 mmHg

Among the patients included, 37.3% experienced CS, 32.7% QS, and 30.0% F. In trabeculectomy blebs, mean pixel intensity (PI) was significantly lower in CS compared with QS and F blebs. Sagittal area values of blebs were significantly greater in CS and QS cohorts compared with F in both the trabeculectomy and deep sclerectomy cohorts.

Researchers observed a “moderate” inverse correlation between maximal bleb height and PI in both trabeculectomy (P<.0001) and deep sclerectomy (P<.0001) groups.

“Image intensity and bleb area values of AS-OCT sagittal slices were significantly associated with CS compared to QS and F,” the authors concluded.


Posarelli M, Tan J, Roney M, et al, et al. Objective quantification of bleb function using swept source anterior-segment optical coherence tomography. Abstract 1868-B0231. Presented at the Association for Research in Vision and Ophthalmology 2024 Annual Meeting, May 5-9, Seattle, Washington.