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array:24 [ "pii" => "S2173579417301123" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.02.014" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1174" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:366-71" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 20 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 6 "PDF" => 9 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669117300709" "issn" => "03656691" "doi" => "10.1016/j.oftal.2017.02.010" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1174" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:366-71" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 98 "formatos" => array:3 [ "EPUB" => 2 "HTML" => 78 "PDF" => 18 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "Estudio prospectivo de las ampollas de filtración poscirugía de implante XEN45" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "366" "paginaFinal" => "371" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prospective study of filtering blebs after XEN45 surgery" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1103 "Ancho" => 1541 "Tamanyo" => 147622 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">BM-LH. Aspecto de ampolla de filtración típica poscirugía XEN (difusa con escasa elevación).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Á. Olate-Pérez, V.T. Pérez-Torregrosa, A. Gargallo-Benedicto, P. Neira-Ibáñez, M. Cerdà-Ibáñez, V. Osorio-Alayo, A. Barreiro-Rego, A. Duch-Samper" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Á." "apellidos" => "Olate-Pérez" ] 1 => array:2 [ "nombre" => "V.T." "apellidos" => "Pérez-Torregrosa" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Gargallo-Benedicto" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Neira-Ibáñez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Cerdà-Ibáñez" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Osorio-Alayo" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Barreiro-Rego" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Duch-Samper" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579417301123" "doi" => "10.1016/j.oftale.2017.02.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301123?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669117300709?idApp=UINPBA00004N" "url" => "/03656691/0000009200000008/v1_201707250054/S0365669117300709/v1_201707250054/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579417301287" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.04.003" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1193" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:372-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 16 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 9 "PDF" => 6 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Efficacy of the SENSIMED Triggerfish<span class="elsevierStyleSup">®</span> in the postoperative follow-up of PHACO-ExPRESS combined surgery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "372" "paginaFinal" => "378" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eficacia del SENSIMED Triggerfish<span class="elsevierStyleSup">®</span> para el seguimiento postoperatorio de la cirugía combinada FACO-ExPRESS" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1368 "Ancho" => 1645 "Tamanyo" => 95725 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Mean IOP-S amplitude (measurement unit: millivolt equivalent/mVeq) during the diurnal (left) and nocturnal periods (right), recorded before (black) and after (green) FACO-ExPRESS surgery with the SENSIMED Triggerfish<span class="elsevierStyleSup">®</span> system. Diminished amplitude curves after surgery can be appreciated (both for the diurnal and nocturnal period), representing a directly proportional reduction of IOP-G in these patients.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. Osorio-Alayo, V.T. Pérez-Torregrosa, R. Clemente-Tomás, Á. Olate-Pérez, M. Cerdà-Ibáñez, A. Gargallo-Benedicto, A. Barreiro-Rego, A. Duch-Samper" "autores" => array:8 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Osorio-Alayo" ] 1 => array:2 [ "nombre" => "V.T." "apellidos" => "Pérez-Torregrosa" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Clemente-Tomás" ] 3 => array:2 [ "nombre" => "Á." "apellidos" => "Olate-Pérez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Cerdà-Ibáñez" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Gargallo-Benedicto" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Barreiro-Rego" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Duch-Samper" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S036566911730134X" "doi" => "10.1016/j.oftal.2017.04.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036566911730134X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301287?idApp=UINPBA00004N" "url" => "/21735794/0000009200000008/v1_201707250047/S2173579417301287/v1_201707250047/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579417300749" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.014" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1128" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:359-65" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 3 "PDF" => 1 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Qualitative analysis of repaired filtering blebs with anterior segment-optical coherence tomography" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "359" "paginaFinal" => "365" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis cualitativo de ampollas de filtración reparadas mediante tomografía de coherencia óptica de segmento anterior" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1225 "Ancho" => 1633 "Tamanyo" => 283429 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">(A) Positive Seidel in bleb prior to repair. (B) Conjunctival advance for the covering. Immediate postop. (C) Subepithelial cysts distributed throughout the bleb surface. (D) Low and homogeneous reflectiveness.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Cerdà-Ibáñez, V.T. Pérez-Torregrosa, A. Olate-Pérez, I. Almor Palacios, A. Gargallo-Benedicto, V. Osorio-Alayo, A. Barreiro Rego, A. Duch-Samper" "autores" => array:8 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Cerdà-Ibáñez" ] 1 => array:2 [ "nombre" => "V.T." "apellidos" => "Pérez-Torregrosa" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Olate-Pérez" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Almor Palacios" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Gargallo-Benedicto" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Osorio-Alayo" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Barreiro Rego" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Duch-Samper" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117300035" "doi" => "10.1016/j.oftal.2016.11.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669117300035?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300749?idApp=UINPBA00004N" "url" => "/21735794/0000009200000008/v1_201707250047/S2173579417300749/v1_201707250047/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Prospective study of filtering blebs after XEN45 surgery" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "366" "paginaFinal" => "371" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Á. Olate-Pérez, V.T. Pérez-Torregrosa, A. Gargallo-Benedicto, P. Neira-Ibáñez, M. Cerdà-Ibáñez, V. Osorio-Alayo, A. Barreiro-Rego, A. Duch-Samper" "autores" => array:8 [ 0 => array:4 [ "nombre" => "Á." "apellidos" => "Olate-Pérez" "email" => array:1 [ 0 => "aolatep@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "V.T." "apellidos" => "Pérez-Torregrosa" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Gargallo-Benedicto" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Neira-Ibáñez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Cerdà-Ibáñez" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Osorio-Alayo" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Barreiro-Rego" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Duch-Samper" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio prospectivo de las ampollas de filtración poscirugía de implante XEN45" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0035" "etiqueta" => "Fig. 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 245 "Ancho" => 1502 "Tamanyo" => 94978 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">AS-OCT. Internal reflectiveness in filtration bleb with a diffuse pattern (corresponding to <a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The techniques comprised in microinvasive glaucoma surgery (MIGS) includes the utilization of AqueSys XEN<span class="elsevierStyleSup">®</span> (AqueSys Inc., California, USA), a valveless tube made of collagen and glutaraldehyde.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1,2</span></a> This device is implanted <span class="elsevierStyleItalic">ab interno</span> by means of an injector, creating an intra-scleral channel through the chamber angle to communicate to the anterior chamber with the subconjunctival space, allowing aqueous humor drainage which generates a filtration bleb.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1,3,4</span></a> The success of the surgery depends on producing a functional bleb as is the case in trabeculectomy.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a> In the latter, it has been described that the morphology of the bleb under biomicroscopy is a good functionality predictor.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">5–8</span></a> However, in the case of the XEN device, the typical characteristics of blebs (diffuse, broad and with low elevation) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>),<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a> make clinic follow-up difficult without the use of supplementary tests. In this context, anterior segment optical coherence tomography (AS-OCT) has proved useful for evaluating filtration bleb functionality in trabeculectomy through morphological characterization, reflectiveness assessment and other quantitative parameters.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">10–14</span></a> In AS-OCT for blebs generated by XEN, reports describe the appearance of cysts in the conjunctival epithelium and hyporeflective strips in the conjunctival thickness and Tenon's capsule during the early post-surgery period.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">9,15</span></a> Despite said qualitative characterization, there are not yet publications reporting long-term changes or modifications thereof, which could be relevant for improved post-surgical management of this recent procedure. The present study aims at analyzing the particular characteristics of filtration blebs developed by the implantation of the XEN device, in a 12-month post-surgery follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Design</span><p id="par0010" class="elsevierStylePara elsevierViewall">A non-controlled prospective study for the qualitative analysis of filtration blebs generated in the postop of surgery combining phacoemulsification and implant of the XEN 45 (FACO-XEN) device by means of AS-OCT and with a follow-up of 12 months. The patients selected for the study had a diagnostic of cataracts and primary open-angle glaucoma. All patients signed an informed consent for the surgery and the present study. The protocol was approved by the Ethics Committee of the authors’ institution and complies with the Helsinki Declaration guidelines as well as the regulations of the current laws of Spain.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Patients</span><p id="par0015" class="elsevierStylePara elsevierViewall">Patients were recruited consecutively in the Glaucoma unit of the Ophthalmology Department. A full ophthalmological examination was carried out in the first visit, including clinical records review and near anamnesis, best corrected visual acuity in the Snellen scale, biomicroscopy with slit lamp (BM-SL), Goldmann applanation tonometry (AT 900; Haag Strait, Berna, Germany), gonioscopy, ocular fundus examination under midriasis, ultrasound pachymetry (OcuScan RxP<span class="elsevierStyleSup">®</span>; Alcon Laboratories, Fort Worth, Texas, USA), IOL Master 500 biometry (Carl Zeiss Meditec, Jena, Germany), Humphrey automated perimetry (HFA II 740i<span class="elsevierStyleSup">®</span>; Carl Zeiss Meditec, Jena, Germany) and retinal nerve fiber layer optical coherence tomography (Cirrus HD-OCT 500<span class="elsevierStyleSup">®</span>; Carl Zeiss Meditec, Jena, Germany). The inclusion criteria comprised previous slight or moderate open-angle primary glaucoma diagnostic (determined by a mean defect between 0 and −12<span class="elsevierStyleHsp" style=""></span>dB in the 24-2 Humphrey campimetry protocol), intraocular pressure (IOP) under 30<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg, with at least 2 hypotensor pharmacological principles, associated cataracts diagnostic with best corrected visual acuity not above 0.6, healthy conjunctival area in the superior nasal quadrant, and age 18 or over. Exclusion criteria included any condition or disease other than those of the inclusion criteria that could increase the difficulty of the surgical procedure or the post-surgery follow-up.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Surgical technique</span><p id="par0020" class="elsevierStylePara elsevierViewall">All the operations were carried out by the same surgeon (V.T.P.T.) and with the same surgical technique. In all cases, peribulbar anesthesia with 2% mepivacaine and 0.5% bupivacaine was administered, with subsequent application of the Honan balloon. Fifteen minutes prior to surgery, 1<span class="elsevierStyleHsp" style=""></span>ml 0.01% mitomycin C was injected subconjunctivally at 12 o’clock and 5<span class="elsevierStyleHsp" style=""></span>mm from the limbus, which was subsequently displaced and distributed with a surgical sponge to the superior nasal sector. After completing cataract surgery that included standard phacoemulsification and placement of acrylic intraocular lens in the capsular sac, 1% acetylcholine was injected in the anterior chamber to contract the pupil, followed by viscoelastic (Healon<span class="elsevierStyleSup">®</span>; Abbott Medical Optics, Uppsala, Sweden) to increase angle opening. The XEN 45 injector needle was introduced in the anterior chamber through an inferior temporal incision previously made for cataract surgery in order to subsequently introduce the needle in the opposite (superior nasal) chamber angle up to subconjunctival visualization 3<span class="elsevierStyleHsp" style=""></span>mm from the limbus, proceeding to the release of the XEN device from the injector. After hydrating the incisions, 0.1<span class="elsevierStyleHsp" style=""></span>ml of 1% cefuroxime was injected in the anterior chamber and betamethasone acetate subtenon (Celestone Cronodose<span class="elsevierStyleSup">®</span>; MSD, Madrid, Spain). Post-surgery care included antibiotic prophylaxis and topical corticoids in decreasing dosage during 2 months.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Follow-up</span><p id="par0025" class="elsevierStylePara elsevierViewall">Post-surgery checkups were made after 24<span class="elsevierStyleHsp" style=""></span>h, and at month 1, 3, 6, 9 and 12. In each checkup patients were assessed with BM-SL measuring IOP with applanation tonometer (previously tuned as per manufacturer specifications) taking at least 2 measurements in each checkup always at the same time of the morning and by the same examiner (A.OR.P.). In addition, AS-OCT was taken at month 3, 6 and 12 after filtration bleb surgery with the anterior segment module of the DRI OCT Triton Swept Source OCT device (Topcon, Tokyo, Japan). All the images were obtained by the same examiner (A.OR.P.) following a preestablished protocol. First, the highest elevation of the bleb in the distal end of the XEN device was identified with BM-SL and fotography. Three scans were taken on each occasion, focused on the conjunctiva, applying the radial tomograph option that captures 12 images (one for each hour of the clock). The scan with the highest quality was selected for taking measurements. In order to ensure data consistency, 2 examiners (A.G.B. and P.N.I.) who were not aware of the clinic condition and IOP of patients, analyzed the images in parallel. For the qualitative assessment, blebs were classified in 3 types according to their pattern and following the classification proposed by Hirooka et al.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> as cystic, diffuse and laminar or layered. The semi-quantitative evaluation comprised a subjective assessment of the internal bleb reflectiveness applying the scale provided by the DRI OCT Triton, classify the blebs as having low and high reflectiveness according to the predominant intensity of the 12 hourly angles obtained. In addition, the inclusion of the quantitative evaluation was considered, measuring bleb height (defined as the perpendicular distance between the first reflective signal of the conjunctiva up to the sclera). If said structures could not be identified by any of the 2 examiners, the analysis was recorded as not feasible.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistical analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">For the purposes of the study, in what concerns bleb functionality surgical success was predefined as diminished IOP to ≤18<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg without the application of hypotensor medicaments. All the statistical analyses were made with SPSS v21.0 for Mac (SPSS Inc., Chicago, IL, USA). The nonparametric Kruskal Wallis test was applied for independent samples in order to compare IOP results between groups. The statistical significance was established at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>0.05.</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Demographic data</span><p id="par0040" class="elsevierStylePara elsevierViewall">Overall, the data of 18 patients and 30 eyes (5 males and 13 females) were analyzed. The age range of the patients was 67–91 (mean 76<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.85 years). Surgery was performed in both eyes of 12 patients and in one eye of 6 patients.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Intraocular pressure and functionality</span><p id="par0045" class="elsevierStylePara elsevierViewall">Mean at presurgery IOP was 21.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.4<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg with 3.07<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.69 hypotensor medicaments. In the post-surgery follow-up, success rate for IOP<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>18<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg, i.e., functional surgery, was 100% at month 3, 96.67% at month 6 and 90% at month 12, with a mean functional bleb IOP of 14.04<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.97, 13.96<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.99 and 14.48<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.89<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg respectively.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Filtration bleb analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">During the follow-up, 3 filtration blebs (3 eyes) lost functionality. The first was defined as encapsulated at follow-up month 6 after being defined as cystic, requiring 3 hypotensor drugs to maintain IOP<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>21<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg at the end of the follow-up period (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The 2 remaining blebs were classified as flat at postop month 12, with each eye requiring one hypotensor drug to maintain IOP<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>21<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg. One eye exhibited a certain degree of subconjunctival fibrosis (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Both had previously been classified as diffuse at follow-up month 3 and with layered pattern at month 6.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">As for functional blebs until follow-up end (27 eyes), qualitative analysis showed that 18.52% (5 eyes) exhibited a cystic pattern, 74.07% (20 eyes) one in layers and 7.41% (2 eyes) one diffuse (<a class="elsevierStyleCrossRefs" href="#fig0020">Figs. 4–6</a> respectively). The most frequent pattern, i.e. diffuse, is characterized by the presence of multiple hypo-reflective strips at different conjunctival levels.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">In what concerns IOP and the morphological pattern of the blebs, those with a cystic structure exhibited a mean IOP of 12.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.79, 12.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.34 and 14.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.0<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg at month 3, 6 and 12, respectively. The blebs with diffuse structure exhibited mean IOP of 13.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.41, 11.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.71 and 13.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.41<span class="elsevierStyleHsp" style=""></span>mm <span class="elsevierStyleHsp" style=""></span>Hg at month 3, 6 and 12 respectively. Finally, the layered pattern exhibited a mean IOP of 14.45<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.96, 14.55<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.88 and 14.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.85<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg at month 3, 6 and 12 respectively.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The semi-quantitative analysis based on the reflectiveness of the functional blebs (27 eyes) demonstrated that the percentage of blebs with low internal reflectiveness during the follow-up period was 51.85% (14 eyes) at month 3, 37.04% (10 eyes) at month 6 and 22.22% (6 eyes) at postop month 12, whereas the percentage of blebs with high reflectiveness was 48.15% (13 eyes), 62.96% (17 eyes) and 77.78% (21 eyes) at month 3, 6 and 12 respectively. As regards IOP and internal bleb reflectiveness, blebs with low reflectiveness exhibited 13.79<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.53, 12.90<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.2 and 12.33<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.82<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg at postop month 3, 6 and 12. Blebs with high reflectiveness exhibited a mean IOP of 14.23<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.35, 14.59<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.12 and 15.14<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.59<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg at month 3, 6 and 12 respectively.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The percentage of cystic blebs with high reflectiveness was 40% at month 3 and 6 (2 eyes) and 60% (3 eyes) at month 12. The blebs with diffuse pattern exhibited high reflectiveness in 50% (one eye) at month 3 and 6, and 100% at month 12 (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>). The blebs with layered pattern exhibited high reflectiveness in 50% (10 eyes) at month 3, 70% (14 eyes) at month 6 and 80% (16 eyes) at month 12.</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The mean height of the functional blebs could not be calculated due to the high percentage of blebs with layered and diffuse pattern which prevented a clear identification of the underlying sclera in all the follow-up period.</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">In an attempt to achieve less traumatic and safer procedures as well as higher effectiveness in diminishing IOP and the use of medicaments for glaucoma, in the past decade a high number of techniques and devices group within MIGS have been developed. The case of the XEN implant has aroused special interest due to its theoretical potential to bring about greater IOP reductions through the subconjunctival pathway for draining the aqueous humor. If we add to this the possibility of utilizing antimetabolites such as mitomycin C as surgery adjuvants or, as defined by Ahmed, MIGS-<span class="elsevierStyleItalic">plus</span>,<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a> the results obtained with this procedure could be enhanced.</p><p id="par0085" class="elsevierStylePara elsevierViewall">However, the higher complexity of the procedure eventually entails specialized and close management of patients. In this context, specific knowledge about the post-surgery evolution of filtration blebs and its similarities and differences vis-à-vis traditional techniques could provide valuable information for improving results.</p><p id="par0090" class="elsevierStylePara elsevierViewall">At present there are no publications on series to compare the results of the present study, although it has been described that it is common to find multiple microcysts in the conjunctival epithelium, hypo-reflective strips in the conjunctiva thickness and Tenon's capsule or the <span class="elsevierStyleItalic">striping</span> phenomenon, as well as poor visualization of the underlying sclera due to the aqueous humor contained in the conjunctival, known as <span class="elsevierStyleItalic">shading</span>, during the early postop. These findings were also previously observed in other types of glaucoma surgeries.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">9,15,17</span></a> This was confirmed in the qualitative analysis of the present study, in which 74.07% of eyes exhibited the layered pattern of the Hirooka classification. This percentage remained stable during the 12-month follow-up. Even so, the authors are unable to tell whether an earlier postop (under 3 months), other types of blebs (cystic or diffuse) would have evolved to the layered pattern. In what concerns functionality, cystic blebs exhibited lower IOP when compared to the layered pattern blebs. This difference was statistically significant in the overall follow-up period (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.003), with similar results to those of studies for other filtrating surgeries.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">The semi-quantitative analysis based on internal bleb reflectiveness demonstrated that the percentage of blebs with high reflectiveness increased globally as well as in each category throughout the post-surgery follow-up period. This could indicate higher cicatrization probability for the long-term and therefore, without intervention, diminished procedure effectiveness. In this regard, IOP was lower in blebs with low reflectiveness when compared to those with hypo-reflectiveness, with statistically significant differences in the overall follow-up period (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.017). These results are similar to studies in other types of surgeries.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">11,14</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">A high percentage of blebs with layered pattern, to which the scleral <span class="elsevierStyleItalic">shading</span> must be added, excluded the possibility of consistent and reproducible measurements in each follow-up period. For this reason the quantitative analysis previously included in the study (bleb height) could not be carried out. Accordingly, the authors considered that qualitative characterization as well as the internal reflectiveness of the filtration bleb increases their relevance when taking decisions for managing patients operated with said technique.</p><p id="par0105" class="elsevierStylePara elsevierViewall">In conclusion, the results of the present study suggest that combined PHACO-XEN surgery generates a low percentage of blebs with failed functionality at 12 months follow-up. Functional blebs with cystic and low reflectiveness characteristics would enable higher IOP reductions. Eventually, IOP increases during follow-up could be related to increased reflectiveness, without exceeding 18<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg. However, studies with higher number of patients and longer-term follow-up periods will be necessary to confirm the results obtained herein and to enable improved and more specific management of patients operated with this technique.</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflict of interests</span><p id="par0110" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres873554" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec862202" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres873555" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec862201" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Design" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Patients" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Surgical technique" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Follow-up" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0040" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Demographic data" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Intraocular pressure and functionality" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "Filtration bleb analysis" ] ] ] 7 => array:2 [ "identificador" => "sec0060" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-08-02" "fechaAceptado" => "2017-02-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec862202" "palabras" => array:7 [ 0 => "Collagen" 1 => "Glaucoma drainage implant" 2 => "Glaucoma/surgery" 3 => "Intraocular pressure" 4 => "Microsurgery" 5 => "Stents" 6 => "Tomography optical coherence" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec862201" "palabras" => array:7 [ 0 => "Colágeno" 1 => "Implante de drenaje glaucoma" 2 => "Glaucoma/cirugía" 3 => "Presión intraocular" 4 => "Microcirugía" 5 => "Stents" 6 => "Tomografía de coherencia óptica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To qualitatively analyze the evolution of filtering blebs after XEN surgery, by using anterior segment optical coherence tomography (AS-OCT).</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A prospective study was performed on filtering blebs of 30 eyes with cataracts and glaucoma, surgically operated on using phacoemulsification and XEN45 implantation (PHACO-XEN). AS-OCT was used to analyze bleb morphology and reflectivity at 3, 6, and 12 months after surgery. Functionality was studied considering an intraocular pressure (IOP)<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>18<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg without antihypertensive medication.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The IOP enabled the blebs to be classified into non-functional: flat (6.67%) and encapsulated (3.33%); and functional (90%), which were then divide by their morphology into cystic (5/27), diffuse (2/27), and layered (20/27). Cystic types had a mean IOP of 12.8, 12.6, and 14.0<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg at 3, 6 and 12 months, respectively. In the diffuse type, the mean IOP was 13.0, 11.5 and 13.0<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg at 3, 6 and 12 months, respectively. In the layers pattern the mean IOP was 14.45, 14.55 and 14.8<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg at 3, 6 and 12 months respectively. The percentage of blebs with high reflectivity was 48.15%, 62.96%, and 77.78%, at 3, 6 and 12 months, with a mean IOP of 14.23, 14.59, and 15.14<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg in each time period, respectively.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">AS-OCT could be a good predictor of bleb functionality in PHACO-XEN surgery. Those with a cystic pattern or low reflectivity seem to have better post-operative success. Nevertheless, more long-term studies are required.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analizar cualitativamente la evolución de las ampollas de filtración mediante tomografía de coherencia óptica de segmento anterior (OCT-SA) en pacientes con implante XEN45.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de las ampollas de filtración de 30 ojos operados de catarata y glaucoma mediante facoemulsificación e implantación XEN45 (FACO-XEN). Se realizó OCT-SA analizando la morfología y la reflectividad de la ampolla al mes 3, 6 y 12 postoperatorio. La funcionalidad se estudió considerando una presión intraocular (PIO)<span class="elsevierStyleHsp" style=""></span>≤18<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg sin medicación hipotensora.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La PIO permitió clasificar las ampollas en no funcionales: planas (6,67%) y encapsuladas (3,33%) y funcionales (90%), las cuales dividimos según su morfología en quísticas (5/27), difusas (2/27) y laminar o en capas (20/27). Las quísticas presentaron una PIO media de 12,8, 12,6 y 14,0<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg a los 3, 6 y 12 meses respectivamente. En las difusas la PIO media fue 13,0, 11,5 y 13,0<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg a los 3, 6 y 12 meses respectivamente. En las de patrón en capas la PIO media fue 14,45, 14,55 y 14,8<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg a los 3, 6 y 12 meses respectivamente. El porcentaje de ampollas con alta reflectividad fue de 48,15%, 62,96% y 77,78% a los 3, 6 y 12 meses, con una PIO media de 14,23, 14,59 y 15,14<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg en cada período, respectivamente.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El análisis de OCT-SA podría ser un buen predictor de la funcionalidad de la ampollas en la cirugía FACO-XEN. Aquellas quísticas o con menor reflectividad parecen tener mejor éxito postoperatorio. Pese a ello, se requieren estudios a mayor largo plazo.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Olate-Pérez Á, Pérez-Torregrosa VT, Gargallo-Benedicto A, Neira-Ibáñez P, Cerdà-Ibáñez M, Osorio-Alayo V, et al. Estudio prospectivo de las ampollas de filtración poscirugía de implante XEN45. Arch Soc Esp Oftalmol. 2017;92:366–371.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Partially presented as a paper at the 92nd Congress of the Ophthalmology Society of Spain, Malaga, Spain.</p>" ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1103 "Ancho" => 1541 "Tamanyo" => 147622 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">BM-SL. Typical post-surgery appearance of XEN filtration bleb (diffuse with slight elevation).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 315 "Ancho" => 1501 "Tamanyo" => 58291 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">AS-OCT. Encapsulated filtration bleb.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 315 "Ancho" => 1501 "Tamanyo" => 38986 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">AS-OCT. Filtration bleb with signs of sub conjunctival fibrosis.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 244 "Ancho" => 1501 "Tamanyo" => 39517 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AS-OCT. Filtration bleb with cystic pattern.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 244 "Ancho" => 1501 "Tamanyo" => 46171 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">AS-OCT. Filtration bleb with layered pattern.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Fig. 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 315 "Ancho" => 1501 "Tamanyo" => 50909 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">AS-OCT. Filtration bleb with diffuse pattern.</p>" ] ] 6 => array:7 [ "identificador" => "fig0035" "etiqueta" => "Fig. 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 245 "Ancho" => 1502 "Tamanyo" => 94978 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">AS-OCT. 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