Influence of Overhanging Bleb on Corneal Higher-Order Aberrations after Trabeculectomy

Recent advances in ocular aberrometry have revealed that ocular surgery increases ocular and corneal higher-order aberrations. This retrospective single-center study aimed to examine the effects of the overhanging bleb on corneal higher-order aberrations using a wavefront analyzer. We included 61 eyes from 50 patients with overhanging bleb after trabeculectomy with a fornix-based conjunctival flap using mitomycin C (overhanging bleb group) and 65 eyes from 54 glaucoma patients with no history of glaucoma surgery (control group). Corneal higher-order aberrations (total higher-order aberrations, coma aberrations, coma-like aberrations, spherical aberrations, and spherical-like aberrations) on a 4 mm pupil diameter were measured using the TOPCON KR-1W wavefront analyzer. Corneal coma aberrations were higher in the overhanging bleb group than in the control group (0.16 +/- 0.13 mu m and 0.10 +/- 0.05 mu m, respectively; p = 0.042). Corneal coma-like aberrations were also higher in the overhanging bleb group than in the control group (0.31 +/- 0.32 mu m and 0.16 +/- 0.09 mu m, respectively; p = 0.022). With an increasing ratio of cornea covered by the bleb to the entire cornea, all corneal higher-order aberrations increased except for corneal coma-like aberrations. Overhanging bleb after trabeculectomy with a fornix-based conjunctival flap using mitomycin C and its size influenced corneal higher-order aberrations.

Automated summary

This study aimed to examine the effects of overhanging bleb on corneal higher-order aberrations. The findings showed that overhanging bleb after trabeculectomy increased corneal coma aberrations and coma-like aberrations. As the ratio of cornea covered by the bleb increased, all corneal higher-order aberrations, except for coma-like aberrations, also increased.