Bleb Morphology of Fornix-Based Versus Limbal-Based Conjunctival Flaps in Trabeculectomy with Mitomycin C

Kyoo Won Lee, M.D.,Ph.D.¹, Soon Cheol Cha M.D., Ph.D. ², Sung Min Hyung, M.D., Ph.D. ³, Joo Hwa Lee, M.D., Ph.D. ⁴,

Cheil Eye Hospital, Daegu, Korea¹
Department of Ophthalmology, College of Medicine, Yeungnam University, Daegu, Koera²
Department of Ophthalmology, College of Medicine, Chungbuk National University, Chungju, Korea³
Department of Ophthalmology, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea⁴

Purpose: To compare the bleb morphology and surgical outcoms of limbal-based group with that of fornix-based group undergone trabeculectomy with mitomycin C (MMC).

Methods: 65 eyes of 59 patients with trabeculectomy with MMC who were observed for 1 year or more were included in the study. A limbal-based conjunctival flap was used for 34 eyes of 31 patients and a fornix-based conjunctival flap for the other 31 eyes of 28 patients. We classified and compared the bleb morphology according to the Moorfield Bleb Grading System after 1 year or more postoperatively, and evaluated intraocular pressure, success rates.

Results: The central bleb vascularity of the limbal-based group was statistically significantly lower than that of fornix-based group (1.79±0.64 : 2.16±0.73, p=0.042). The risk of cystic bleb formation was higher in the limbal-based group (38.2% : 16.5%, p=0.047). There were no differences in the IOP and success rate in two groups.

Conclusions: There were no differences between the groups in the IOP and cumulative success rate, but fornix-based group was recommendable concerning the low risk of cystic bleb formation.