An ultrasound biomicroscopic study of filtering blebs after mitomycin C trabeculectomy

Ophthalmology. 1995 Dec;102(12):1770-6. doi: 10.1016/s0161-6420(95)30795-6.


Purposes: To investigate the relation between filtering bleb function and ultrasound biomicroscopic images, and to establish a new classification system for filtering blebs according to these images.

Methods: After trabeculectomy with mitomycin C, the filtering blebs of 117 eyes from 117 patients with various types of glaucoma were examined using ultrasound biomicroscopy. Four parameters of the images-intrableb reflectivity, visibility of the route under the scleral flap, formation of a cavernous fluid-filled space, and bleb height-were correlated with the level of intraocular pressure (IOP).

Results: Reflectivity inside the bleb and visibility of a route under the scleral flap were highly associated with IOP control. Blebs were classified into four categories according to the four measured parameters: type L (low-reflective), type H (high-reflective), type E (encapsulated), and type F (flattened). Eyes with good IOP control had mainly type L blebs. Type E and type F blebs were seen mostly in eyes requiring additional medication.

Conclusion: The structure inside a filtering bleb is visible by ultrasound biomicroscopy, and bleb function is significantly associated with its ultrasound biomicroscopic image in eyes trabeculectomized with adjunctive mitomycin C.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anterior Eye Segment / diagnostic imaging*
  • Anterior Eye Segment / drug effects
  • Anterior Eye Segment / surgery
  • Antibiotics, Antineoplastic / administration & dosage*
  • Chemotherapy, Adjuvant
  • Child
  • Female
  • Glaucoma / diagnostic imaging*
  • Glaucoma / drug therapy
  • Glaucoma / surgery
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage*
  • Ostomy*
  • Sclera / diagnostic imaging
  • Trabeculectomy*
  • Ultrasonography


  • Antibiotics, Antineoplastic
  • Mitomycin