A comparison of intrascleral bleb height by anterior segment OCT using three different implants in deep sclerectomy

Abstract

Purpose: To compare intrascleral blebs characteristics after deep sclerectomy (DS) with three intrascleral implants using the Visante anterior segment optical coherence tomography.

Methods: This is a cross-sectional study including 60 eyes of 51 patients that underwent DS with Sk-Gel, Esnoper, and Aquaflow implant. Intraocular pressure (IOP) measurement, slit-lamp examination, and Visante scans were performed the same day in all the patients. Visante scans were done through the intrascleral bleb at 45°, 90°, and 135° and the bleb height was measured.

Results: Sk-Gel was used in 19 eyes (31.66%), Esnoper in 22 eyes (36.66%), and Aquaflow in 19 eyes (31.66%). The median time lapsed from the surgery was 15.50 months 25th and 75th percentiles (p(25) 8.25; p(75) 20). The median IOP was 13 mm Hg (p(25) 10; p(75) 15), with no significant differences among implants (P = 0.232). Overall, the correlation between the scleral bleb height and the IOP was statistically significant at 45° (r=-0.359; P = 0.004), 90° (r = -0.410; P = 0.001), and 135° (r = -0.417; P = 0.001). However, Sk-Gel did not show any statistically significant correlation between the scleral height and IOP whereas the other two groups (Esnoper and Aquaflow) showed a significant correlation. There were no differences in the bleb height among implants.

Conclusion: There was a moderate inverse correlation between the scleral bleb height and the IOP measurement after DS with Esnoper and Aquaflow implants. There were no differences in bleb height among the three implants.

Figure 1

Measurement of intrascleral bleb height. The maximum height of the intrascleral bleb in each scan was manually measured with the OCT caliper tool and automatically calculated with the device's software.