الفهرس 
Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Trabeculectomy has been the standard surgical treatment for glaucoma since 1960. The surgical outcome depends mostly on the resulting IOP. The description of the morphology and the function of the bleb are usually essential to a favorable outcome. Bleb grading systems identified and incorporated a graded assessment of various bleb parameters such as vascularity, height, width, microcystic changes, and diffuse demarcated zones with reference to clinical and photographic standards. The preservation of the aqueous drainage route beneath the trabeculectomy scleral flap cannot be evaluated by conventional slit-lamp examination.
The recent development of the UBM device has made it possible to observe the detailed structure of the anterior segment of the eye with a noninvasive procedure.
Qualitative assessment of the bleb by UBM found that the bleb type was associated with IOP control. Using UBM, four categories were described: low, high, flattened, and encapsulated.
In normal eyes, the main outflow resistance appears to occur at the juxta canalicular connective tissue layer of the trabecular meshwork. This area is by-passed by the surgical procedure, allowing the passage of fluid from the anterior chamber to the intrascleral space.
In eyes that had undergone trabeculectomy, the development of a filtering bleb was correlated with the efficiency of filtrations beneath the scleral flap. It has long been believed that the development of a filtering bleb and the micro-architecture of the connective tissue in the bleb influence the IOP during the long-term postoperative follow-up.
The use of UBM permits the detailed noninvasive observation of the inner architecture of the bleb after trabeculectomy. Thus, the preservation of the aqueous drainage route beneath the scleral flap probably influenced the development of a filtering bleb after a trabeculectomy.
This study aimed to evaluate the role of UBM in assessing uneventful trabeculectomy operation parameters (anterior chamber depth, iris profile, maximal height and the extent of the bleb, intrableb reflectivity, patency of the aqueous drainage route and patency of the peripheral iridectomy).
In this prospective cohort study, analysis of UBM scanning of 30 eyes after uneventful trabeculectomy operation was done.
The summary of our results:
Age ranged from (52-71) years with mean value 61.67 ± 5.18 years. There were 11 male patients (36.7%) and 19 female patients (63.3%). There were 15 patients having POAG type of glaucoma and another equal number having the PACG type.
Anterior chamber Depth ranged from (2-3.5) mm with mean value 2.60 ± 0.36 mm.
There were 25 patients having patency of sclerostomy (83.3%) meanwhile, 5 patients don’t have (16.7%).
Summary
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There were 21 patients having straight iris profile (70.0%) meanwhile, 9 patients have steep one (30.0%).
IOP ranged from (11-37) mmHg with mean value 17.27 ± 7.47 mmHg.
There were 13 patients having high bleb reflectivity (52.0%) meanwhile, 12 patients have low one (40.0%).
Bleb size ranged from (9-20.4) mm2 with mean value 13.87 ± 3.08 mm2.
There was negative strong significant correlation between bleb size and IOP. There was positive weak difference at anterior chamber depth and IOP. There was positive strong significant difference at bleb reflectivity and IOP.
By simple linear regression, IOP = -1.1345 x (bleb size) + 30.384.
Multiple regression analysis showed that both bleb size and reflectivity affect IOP, but anterior chamber depth doesn’t.