Abstract

P 109

Objective quantification of bleb vascularisation in early follow-up period after trabeculectomy

Kathrin Laaser, Felix Bock, Kristina Gottschalk, Christopher Rössler, Ursula Schlötzer-Schrehardt, Friedrich E. Kruse, Anselm G. M. Jünemann
Universitäts-Augenklinik Erlangen

Objective
Using 5-FU after trabeculectomy is a possibility to reduce scar formation. Currently there is no consensus about the optimal time and the amount of 5-FU interventions.
Aim of this study was the objective quantification of bleb vascularisation in early follow-up period after trabeculectomy while using 5-FU. Using 5-FU after trabeculectomy is a possibility to reduce scar formation. Currently there is no consensus about the optimal time and the amount of 5-FU interventions.
Aim of this study was the objective quantification of bleb vascularisation in early follow-up period after trabeculectomy while using 5-FU.
Methods
This study included 10 eyes of patients with primary open-angle glaucoma (POAG). After trabeculectomy with mitomycin C (0.3mg/ml, one surgeon) a mean of 4.4 subconjunctival 5-FU applications were performed within the following 9.4±4.1 days. 5-FU application was started 4.4±1.5 days postoperatively. The blebs were documented using analog color photographs according to a standardized protocol (slit lamp photograph in down-gaze, 10fold magnification). The morphometric analysis of the bleb vascularization was performed using a digital image analysis software (cell^F: Olympus Hamburg, Germany). An optimized filter set was used for the detection of the vessels. The vascularisation of the bleb was given as percentage of the total bleb area.
Results
The amount of vascularized area of all blebs was 24.5±7.0 % before the initiation of 5-FU therapy. During the follow-up it decreased to 20.5 ±4.8%. This reduction of bleb vascularisation was not significant (p= 0.054).
Conclusions
The clinically observed decrease of bleb vascularsation during 5-FU therapy can be quantified semiautomatically. The statistical trend found in this study may reach significance in a larger number of subjects thus conclusions may obtained about timepoint and number of 5-FU injections.

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