Comparison of conjunctival vascularity changes using optical coherence tomography angiography after trabeculectomy and phacotrabeculectomy

  • Je Hyun SeoEmail author
  • Young Lee
  • Jong Hoon Shin
  • Ye An Kim
  • Keun Heung Park



To compare bleb vascularity changes using optical coherence tomography angiography (OCT-A) between mitomycin-C (MMC)-augmented trabeculectomy and phacotrabeculectomy and to determine whether bleb vascularity measurements during preoperative and early postoperative periods could act as surrogate parameters to predict surgical outcomes.


We retrospectively reviewed data for 72 eyes from 72 glaucoma patients who underwent MMC-augmented trabeculectomy with/without cataract surgery. Bleb area scans were obtained using OCT-A during the preoperative period; 1, 2, 4, and 6 weeks postoperatively; and 2, 4, and 6 months postoperatively. For conjunctival vascularity analysis, a semi-automated program was used to calculate color and brightness densities of the selected area.


Color and brightness densities were decreased in the trabeculectomy group during all periods but not in the phacotrabeculectomy group at 4 and 6 weeks, as well as 2, 4, and 6 months postoperatively. Color and brightness densities were significantly higher in the phacotrabeculectomy group than in the trabeculectomy group after 6 weeks and 2, 4, and 6 months postoperatively. A Kaplan-Meier survival graph indicated that intraocular pressure differed according to glaucoma type but not surgery type. Logistic regression analysis revealed that brightness density 1 week postoperatively was correlated with reoperation.


Changes in conjunctival vascularity density measured by OCT-A differed according to the surgical method. Following trabeculectomy with MMC, brightness density 1 week postoperatively may be a predictive index for surgical outcomes.


Conjunctiva Glaucoma Optical coherence tomography angiography Vascularity Phacotrabeculectomy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval retrospective studies

As this study was designed retrospectively, which was conducted on already available data, for which formal consent is difficult to obtain, the Pusan National University Yangsan Hospital Institutional Research Committee approved the consent waiver on the assumption that the security of personal information is well managed (IRB No. 05-2017-146).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Veterans Medical Research Institute, Veterans Health Service Medical CenterSeoulSouth Korea
  2. 2.Department of OphthalmologyPusan National University Yangsan HospitalYangsanSouth Korea
  3. 3.Division of Endocrinology, Department of Internal Medicine, Veterans Health Service Medical CenterSeoulSouth Korea
  4. 4.Department of OphthalmologyPusan National University HospitalBusanSouth Korea

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