Correlation Between Bleb Trabeculectomy Morphology With Intraocular Pressure In Primary Glaucoma

1. Dr. Dian Estu Yulia¹
2. Prof.Dr.Edi Supiandi, SpM¹
3. DR. Dr. Widya Artini, SpM¹
4. Dr. Joedo Prihartono, MPH¹

¹University of Indonesia / Ciptomangunkusumo Hospital, Jakarta, Indonesia

Purpose
To evaluate the correlation between bleb morphology and intraocular pressure in primary glaucoma post trabeculectomy patients

Methods
A serial descriptive prospective study based on follow up time was conducted. Trabeculectomy surgery were done in twenty four eyes primary glaucoma patients. Intraocular pressure was measured by Goldmann applanation method meanwhile bleb morphology grading was assessed using standard photograph taken from Moorfields Bleb Grading System (MBGS). Evaluation for IOP and bleb morphology was done on day 1,7,14 and 30 post operatively.

Results
Twenty-four subjects (sixteen angle closure and eight open angle primary glaucoma) were followed-up for 1 month. Mean age in this study is 58,4 ± 9,5 years. All subjects had IOP ≤ 21 mmHg on the 1,7 and 14 day although two subjects reached IOP > 21 mmHg (23 and 22 mmHg) on the thirteeth day. There was tendency of increasing mean IOP meanwhile all variable of morphology bleb (central demarcated and maximal area, height, vascularization) had decreasing gradation in average. Statistical analysis to find correlation between each variable with post operative IOP only could be done on day 30 and it was not significant statistically.

Conclusions
Mean intraocular pressure post trabeculectomy had increased from first day until thirteeth day eventhough this score still less than 21 mmHg on 91,7% subjects. The gradation of each variable bleb morphology (central demarcated and maximal area, height, vascularization) had decreased meanwhile IOP tended to increase postoperatively according to follow up time. On thirteeth day, the correlation between each variable bleb morphology with IOP was not significant statistically.