Comparison of diamond and metal blade for scleral flap dissection in Trabeculectomy, using an anterior segment optical coherence tomography

摘要: Purpose: To evaluate and compare the characteristics of the filtering bleb and scleral flap in trabeculectomy, created with a diamond or metal blade, using an anterior segment optical coherence tomography (AS-OCT).Methods: We enrolled patients after a first trabeculectomy, in which the scleral flap was created using a diamond or metal blade, and continued follow up in our clinic by a glaucoma specialist. An AS-OCT was done at least 6 months post operation and analyzed for bleb height, bleb-wall thickness and para-scleral drainage route in the anterior and posterior parts of the scleral flap. Operative success was defined as IOP reduction of 30% and bellow 18 mmHg, addition of medication was considered as qualified success.Results: 32 eyes (of 30 patients) were evaluated, 18 in the diamond blade group (DB) and 14 in the metal blade (MB) group. Success rate was 94.44% and 71.43%, respectively. Preoperative IOP was 23.33±7.09 [range 12-38 mmHg] in the DB group and 23.43±4.97 [range 16-36 mmHg] in the MB group. A mean IOP reduction at last follow up was 11.56±7.42 and 10.43±5.35 mmHg, respectively, with a lower medication rate in the DB group: 0.7 vs 1.7.