Ultrasound Biomicroscopic Evaluation of Anterior Segment Parameters and Surgical Area Following Trabeculectomy Surgery

Objectives: This study used ultrasound biomicroscopy (UBM) imaging to evaluate the anterior segment structure and surgical area of patients with open angle glaucoma following a trabeculectomy procedure. Methods: Consecutive patients with primary open angle or pseudoexfoliative glaucoma who underwent a trabeculectomy were included. UBM was used to examine the anatomical parameters of anterior chamber depth, anterior chamber angle, angle opening distance at 500 µm (AOD500), trabecular ciliary process distance (TCPD), iris ciliary process distance, scleral ciliary process angle (SCPA), and ciliary process thickness, as well as the internal ostium opening, ostium-iris distance, and scleral flap dimensions. Bleb morphologies were evaluated qualitatively using the Yamamoto classification and quantitatively according to the presence of drainage from the medial, lateral, and posterior borders. Results: Twenty-five eyes of 23 patients (4 female, 19 male) were included in the study. The TCPD and SCPA measurements were significantly greater in the postoperative third month (1.04±0.12 mm vs 1.09±0.16 mm, p


1. Grehn F, Hollo G, Lachtar Y, Migdal C, Thygesen J. Incisional Surgery, Treatment Principles and Options. In: Traverso CE, editor. Terminology and Guidelines for Glaucoma. 4th ed. Savona, Italy: PubliComm; 2014. p. 169–71.

2. Razeghinejad MR, Fudemberg SJ, Spaeth GL. The changing conceptual basis of trabeculectomy: a review of past and current surgical techniques. Surv Ophthalmol 2012;57:1–25.

3. Liebmann LM, Ritch R. Complications of glaucoma filtering surgery. In: Ritch R, Shields B, Krupin T, editors. The Glaucomas. St. Louis: CV Mosby; 1996. p. 1703–36.

4. Herndon LW. Complications of Glaucoma Surgery and their Management. In: Yanoff M, Duker JS, editors. Ophthalmology. 4th ed. Elsevier Saunders; 2013.

5. Chen CW, Huang HT, Bair JS, Lee CC. Trabeculectomy with simultaneous topical application of mitomycin-C in refractory glaucoma. J Ocul Pharmacol 1990;6:175–82.

6. Greenfield DS, Miller MP, Suner IJ, Palmberg PF. Needle elevation of the scleral flap for failing filtration blebs after trabeculectomy with mitomycin-C. Am J Ophthalmol 1996;122:195–204.

7. Pavlin CJ, Harasiewicz K, Sherar MD, Foster FS. Clinical use of ultrasound biomicroscopy. Ophthalmology 1991;98:287–95.

8. Pavlin CJ, Harasiewicz K, Foster FS. Ultrasound biomicroscopy of anterior segment structures in normal and glaucomatous eyes. Am J Ophthalmol 1992;113:381–9.

9. Yamamoto T, Sakuma T, Kitazawa Y. An ultrasound biomicroscopic study of filtering blebs after mitomycin C trabeculectomy. Ophthalmology 1995;102:1770–6.

10. Golez E 3rd, Latina M. The use of anterior segment imaging after trabeculectomy. Semin Ophthalmol 2012;27:155–9.

11. Nakano N, Hangai M, Nakanishi H, Inoue R, Unoki N, Hirose F, et al. Early trabeculectomy bleb walls on anterior-segment optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2010;248:1173–82.

12. McWhae JA, Crichton AC. The use of ultrasound biomicroscopy following trabeculectomy. Can J Ophthalmol 1996;31:187–91.

13. Avitabile T, Russo V, Uva MG, Marino A, Castiglione F, Reibaldi A. Ultrasound- biomicroscopic evaluation of filtering blebs after laser suture lysis trabeculectomy. Ophthalmologica 1998;212:17–21.

14. El Salhy AA, Elseht RM, Al Maria AF, Shalaby SMAE, Hossein TR. Functional evaluation of the filtering bleb by ultrasound biomicroscopy after trabeculectomy with mitomycin C. Int J Ophthalmol 2018;11:245–50.

15. Martínez-Belló C, Rodriguez-Ares T, Pazos B, Capeáns C, Sánchez-Salorio M. Changes in anterior chamber depth and angle width after filtration surgery: A quantitative study using ultrasound biomicroscopy. J Glaucoma 2000;9:51–5.

16. Park SW, Heo H, Yang KJ. Comparison of ultrasound biomicroscopic changes after glaucoma triple procedure and trabeculectomy in eyes with primary angle closure glaucoma. J Glaucoma 2009;18:311–5.

17. Tello C, Liebmann J, Potash SD, Cohen H, Ritch R. Measurement of ultrasound biomicroscopy images: intraobserver and interobserver reliability. Invest Ophthalmol Vis Sci 1994;35:3549–52.

18. Marchini G, Pagliarusco A, Toscano A, Tosi R, Brunelli C, Bonomi L. Ultrasound biomicroscopic and conventional ultrasonographic study of ocular dimensions in primary angle closure glaucoma. Ophthalmology 1998;105:2091–8.

Kaynak Göster