Anterior segment optical coherence tomography imaging of trabeculectomy blebs before and after laser suture lysis

PURPOSE: To image trabeculectomy blebs before and after laser suture lysis (LSL) using anterior segment optical coherence tomography (AS-OCT). DESIGN: Prospective observational study. METHODS: Blebs were imaged with a prototype of the AS-OCT (Carl Zeiss Meditec, Inc, Dublin, California, USA) before and after LSL. Blebs were assessed for bleb height, bleb wall thickness, apposition of the scleral flap to sclera, and patency of the internal ostium. RESULTS: Seven blebs in eyes of seven patients were imaged. Pre-LSL, five blebs were low and two were of moderate height. After LSL, six of seven eyes (85.7%) showed an increase in total bleb height, with increased bleb wall thickness and separation of the scleral flap from sclera. In one eye, there was no discernible change in bleb height, cavity height, or wall thickness. CONCLUSIONS: AS-OCT was able to demonstrate features of bleb morphology that changed after LSL.