Original article
Qualitative analysis of repaired filtering blebs with anterior segment-optical coherence tomography
Análisis cualitativo de ampollas de filtración reparadas mediante tomografía de coherencia óptica de segmento anterior
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
Corresponding author
Departamento de Oftalmología, Hospital Clínico Universitario, Valencia, Spain
Read
5
Timeswas read the article
2
Total PDF
3
Total HTML
Share statistics
array:24 [ "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" "copyrightAnyo" => "2017" "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 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669117300035" "issn" => "03656691" "doi" => "10.1016/j.oftal.2016.11.015" "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" => 84 "formatos" => array:3 [ "EPUB" => 4 "HTML" => 63 "PDF" => 17 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "Análisis cualitativo de ampollas de filtración reparadas mediante tomografía de coherencia óptica de segmento anterior" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "359" "paginaFinal" => "365" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Qualitative analysis of repaired filtering blebs with anterior segment-optical coherence tomography" ] ] "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" => 1225 "Ancho" => 1633 "Tamanyo" => 283429 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A) Seidel positivo en ampolla previa a la reparación. B) Avance conjuntival para el recubrimiento. Postoperatorio inmediato. C) Quistes subepiteliales distribuidos en toda la superficie de la ampolla. D) Baja reflectividad y homogénea.</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" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579417300749" "doi" => "10.1016/j.oftale.2017.03.014" "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/S2173579417300749?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669117300035?idApp=UINPBA00004N" "url" => "/03656691/0000009200000008/v1_201707250054/S0365669117300035/v1_201707250054/es/main.assets" ] ] "itemSiguiente" => array:19 [ "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" "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 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Prospective study of filtering blebs after XEN45 surgery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "366" "paginaFinal" => "371" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio prospectivo de las ampollas de filtración poscirugía de implante XEN45" ] ] "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" => "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>" ] ] ] "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" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117300709" "doi" => "10.1016/j.oftal.2017.02.010" "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/S0365669117300709?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301123?idApp=UINPBA00004N" "url" => "/21735794/0000009200000008/v1_201707250047/S2173579417301123/v1_201707250047/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579417300385" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.02.006" "estado" => "S300" "fechaPublicacion" => "2017-08-01" "aid" => "1129" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:353-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 4 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Mediterranean diet adherence by patients with primary open angle glaucoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "353" "paginaFinal" => "358" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Adherencia a la dieta mediterránea en pacientes afectos de glaucoma primario de ángulo abierto" ] ] "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" => 2854 "Ancho" => 2081 "Tamanyo" => 589166 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Questionnaire utilized in the study.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.A. Abreu-Reyes, D. Álvarez-Luis, V. Arteaga-Hernández, M. Sánchez-Mendez, R. Abreu-González" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J.A." "apellidos" => "Abreu-Reyes" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Álvarez-Luis" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Arteaga-Hernández" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Sánchez-Mendez" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Abreu-González" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117300047" "doi" => "10.1016/j.oftal.2016.12.002" "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/S0365669117300047?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300385?idApp=UINPBA00004N" "url" => "/21735794/0000009200000008/v1_201707250047/S2173579417300385/v1_201707250047/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Qualitative analysis of repaired filtering blebs with anterior segment-optical coherence tomography" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "359" "paginaFinal" => "365" ] ] "autores" => array:1 [ 0 => array:4 [ "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:4 [ "nombre" => "M." "apellidos" => "Cerdà-Ibáñez" "email" => array:1 [ 0 => "mcerdaib@gmail.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" => "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" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Oftalmología, Hospital Clínico Universitario, 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" => "Análisis cualitativo de ampollas de filtración reparadas mediante tomografía de coherencia óptica de segmento anterior" ] ] "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>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Late Seidel is understood to mean the exit of aqueous humor occurring over 2 months after surgery. In filtering blebs, this is usually associated to the incorrect use of metabolites.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,2</span></a> The prevalence of late leaks is higher after phacotrabeculectomy than after phacoemulsification and nonperforating deep sclerectomy utilizing intra-surgery mitomycin C in both techniques.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">3,4</span></a> Clinic can be highly variable, ranging from no symptoms at all up to epiphora (“hot tears”) or discomfort related to the bleb. In contrast with early leaks, the anterior chamber generally maintains normal depth and the bleb usually exhibits variable degrees of elevation. Surgical repair is required to avoid associated complications such as hypotony, choroidal detachment or endophthalmitis. On the other hand, the survival of the surgical repair through conjunctival advance depends on the quality of the conjunctiva, the use of metabolites and the number of previous surgeries.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A series of 10 cases that required reconstructive surgery of the bleb is presented. Said surgery comprised conjunctival advance and subsequent study for analyzing filtering bleb morphology, as well as the survival thereof and the condition of the overlying conjunctiva by means of OCT-SA images.</p><p id="par0015" class="elsevierStylePara elsevierViewall">OCT-SA arose due to the need of quantitatively analyzing the anterior segment. It utilizes the principle of low coherence interferometry and achieves a resolution between 10 and 25 times higher than that obtained by ultrasound biomicroscopy despite lower penetration in tissue. OCT-SA produces anterior segment images by modifying the instrument focus of the valid and reproducible images of the cornea, the iris and the iris-corneal angle. OCT-SA software enables the exploration of the corneal, scleral and angle structure with a white-white scanner that simultaneously shows angles.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Subjects, material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A prospective and observational study carried out in the course of 6 months comprising 10 eyes that required filtering bleb covering through conjunctival advance after exhibiting late Seidel. The demographic data of patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The blebs were large and located at the posterior level. For this reason, surgical repair was based on conjunctival advance.</p><p id="par0030" class="elsevierStylePara elsevierViewall">After applying peribulbar anesthesia, a traction with 5/0 nylon anchored to the upper cornea was made to traction the eye in the inferior direction. The size of the bleb was measured and it was isolated dissecting the surrounding conjunctiva. The bleb was completely covered with the conjunctiva and Tenon after carrying out a horizontal incision in the upper fornix in order to facilitate the conjunctival advance, which was fixed with loose 8/0 silk stitches to the cornea. In 4 cases, the relaxing conjunctival incision formed a second scar and in 6 cases it was sutured with 8/03 absorbable suture.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The images were obtained 6 months after said repair with slit lamp and OCT-SA DRI Triton (Topcon<span class="elsevierStyleSup">®</span>). Said OCT utilizes swept source technology and a wavelength of 1050<span class="elsevierStyleHsp" style=""></span>nm, producing high resolution images with tangential and radial anterior pole scanners, obtaining the image in the area of the highest of bleb elevation. The slit lamp images were taken in standard lighting and magnification conditions.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The bleb morphology was analyzed on the basis of the patterns described by Hirooka et al.,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> i.e., cystoid or cystic, laminar or diffuse.</p><p id="par0045" class="elsevierStylePara elsevierViewall">In addition, the presence, location and number of cysts were also studied, together with reflectiveness and the form of the “intra-bleb” walls, as well as the covering thereof at the conjunctiva and Tenon (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">The patients included in the study were between 45 and 88 years of age. They had previously undergone glaucoma surgery (trabeculectomy associated to mitomycin at various concentrations and time periods). In 5 patients, this surgery was combined with cataract surgery. In addition to the appearance of Seidel in the bleb, 4 patients exhibited complications such as choroidal detachment, blebitis or endophthalmitis, that were resolved prior to the bleb repair (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Tension results, associated complications and bleb morphology are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Seven of 10 patients had a bleb that followed a cystic pattern, with small subepithelial cysts distributed under the superior wall. The walls showed hypo-reflectiveness and the bleb covering, formed by Tenon and the conjunctiva, was complete (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Two cases exhibited a diffuse pattern that could not be classified in a specific group, and did not include any cyst throughout the bleb surface. The inside of the blebs exhibited thinned walls, leaving aqueous humor spaces between them in the form of small lakes. These walls exhibited variable reflectiveness. Covering comprised by conjunctiva and tenon did not exist, with reappearance of Seidel (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Lastly, one patient exhibited a multilayer pattern with intermediate morphology comprising some small subtenon diffuse cysts, with intermediate reflectiveness and the internal walls and bleb covering only with Tenon (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">In contrast with early leaks, in late leaks conservative measures are not effective and the main problem is that frequently bleb surgery determines a partial or complete loss of tension control. For this reason it was decided to perform a surgical repair based on conjunctival advance. It was not necessary to associate scleral flaps to the reconstruction procedure as they did not exhibit dissolution or thinning.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The slit lamp image was not useful for an early evaluation of bleb functionality as it depends on internal structures which are visible with OCT-SA. The variables modifying the functionality thereof are wall thickness and reflectiveness. In addition, the presence and number of micro-cysts must also be analyzed.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The patients were classified on the basis of the OCT-SA images and were grouped in three patterns as those described by Hirooka et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> None of the patients exhibited entirely the characteristics described by said author, and it is assumed that this is because the present cases were blebs that required surgical repair after an initial failure.</p><p id="par0085" class="elsevierStylePara elsevierViewall">The uniform reflectiveness of the blebs that did not exhibit Seidel relapse is worthy of note, whereas heterogeneous and high reflectiveness was observed in cases exhibiting conjunctival retraction and reappearance of late leaks. It is believed that these hypo-reflectiveness areas in the walls of mature blebs are aqueous humor aggregates.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">6,7</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Previous slit lamp studies found that the presence of cysts in the early or late postop is associated to improved performance of mature blebs.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> The present study found that the persistence of microcysts 6 months after surgical repair is related to satisfactory formation and adequate performance of the bleb (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">A limitation of the present study is the low number of patients and the lack of correlation of the findings with variables that clinically affect bleb performance, such as vascularization thereof, associated inflammatory or infectious processes, which were not studied. However, the authors did observe that the poor responses occurred with blebs of which a diffuse pattern was previously obtained, regardless of whether they had exhibited previous complications (endophthalmitis, choroidal detachment, etc.). The patients who exhibited complications in the beginning exhibited a cystic pattern after repair, with satisfactory evolution by month 6. Accordingly, in the present group of patients, the presence of previous infectious processes did not give rise to poor evolution in bleb covering repair and did not modify the pattern regarded as a positive response to repair.</p><p id="par0100" class="elsevierStylePara elsevierViewall">An additional factor to be taken into account when analyzing said blebs with OCT-SA is the presence of artifacts.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> One of the described artifacts consist in the fact that the external wall that covers the bleb is placed in the upper third of the scanner. In these cases, a significant increase in reflectiveness is observed. The present results were obtained utilizing the middle third because, if the wall was placed in the upper third, all the walls would appear diffuse due to the scanner characteristics. However, a bleb with a diffuse pattern could simulate a multilayer pattern if placed in the lower third.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> It is important to obtain reference points so that the external wall is always placed in the middle third. The bleb size is also modified depending on where it is placed due to the characteristics of the OCT-SA device that has 12–16<span class="elsevierStyleHsp" style=""></span>mm scanning capacity in the anterior pole. An additional potential cause of artifacts is the presence of subconjunctival hemorrhages that create reflectiveness increases due to blood. For this reason, the study of the present blebs was carried out 6 months after surgery.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The findings of the present study were taken with an OCT-SA device having 1050<span class="elsevierStyleHsp" style=""></span>nm wavelength, which is very useful to observe intra-scleral flow. Other OCT-SA devices with lower wavelengths could present difficulties for producing images at a deeper level although, according to previous studies, the different OCT-SA wavelengths do not affect the study of bleb survival because more superficial factors are taken into account, such as wall cicatrization.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">By way of conclusion, OCT-SA demonstrates the capacity to perform a detailed analysis of the filtering bleb (internal structure and covering) as well as survival. It also assists in the indication of postoperative maneuvers such as conjunctival advances, placement of instruments for regulating cicatrization or placing biomembranes.</p><p id="par0115" class="elsevierStylePara elsevierViewall">A combines diagnostic comprising a standard clinic evaluation, together with slit lamp and OCT-SA images could enable greater clinic control of patients and early therapeutic decision-making processes whenever required.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interests</span><p id="par0120" 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" => "xres873550" "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" => "xpalclavsec862197" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres873549" "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" => "xpalclavsec862198" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Subjects, material and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-09-11" "fechaAceptado" => "2016-11-24" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec862197" "palabras" => array:6 [ 0 => "Anterior segment optic coherence tomography" 1 => "Filtering bleb" 2 => "Filtering bleb leaks" 3 => "Bleb morphology" 4 => "Cystoid pattern" 5 => "Conjuctival retraction" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec862198" "palabras" => array:6 [ 0 => "Tomografía de coherencia óptica de segmento anterior" 1 => "Ampolla de filtración" 2 => "Seidel en ampollas de filtración" 3 => "Morfología de la ampolla" 4 => "Patrón quístico" 5 => "Retracción conjuntival" ] ] ] ] "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 provide a qualitative analysis of filtering blebs after being surgically repaired due to late blebs leaks.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Blebs were studied 6 months after surgical reparation using AS-OCT Triton (Topcon<span class="elsevierStyleSup">®</span>). An analysis was made of the morphological pattern and internal structures of blebs, including the covering, in 10 patients. The images were obtained using OCTs at a wavelength of 1050<span class="elsevierStyleHsp" style=""></span>nm.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">According to the Hirooka classification, three different patterns were found in the structure of blebs, which made it possible to correlate them with their functionality. A full covering was observed in 70% of the cases, and they showed sub-epithelial cysts (cystoid pattern). Two cases showed a full conjunctival retraction without Tenon's covering. The walls were thin, with a de-structured bleb (diffuse pattern) being visualized. In the third group, the image showed a partial conjunctival retraction with Tenon's covering. There were some sub-epithelial diffuse cysts with walls following a laminar pattern.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Using AS-OCT, it is possible to study the bleb's characteristics in detail, as well as the cover, in the case of blebs requiring repair due to late leaks, using conjunctival advancement. It allows for the early visualization of conjunctival retractions that were not visible in a slit lamp, and to predict the functionality of the blebs by their morphology.</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">Realizar un análisis cualitativo de las ampollas de filtración que han sido reparadas quirúrgicamente por presentar Seidel tardío.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de 10 ampollas de filtración que requirieron reparación quirúrgica mediante la OCT-SA Triton (Topcon<span class="elsevierStyleSup">®</span>). Se analizó, a los 6 meses de la cirugía, el patrón morfológico y las estructuras internas de las mismas, así como el estado del recubrimiento. La obtención de las imágenes fue mediante longitudes de onda de 1.050<span class="elsevierStyleHsp" style=""></span>nm.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Según la clasificación de Hirooka, encontramos 3 patrones diferentes en la morfología de la ampolla que pudimos relacionar con la funcionalidad de la misma. En un 70% de los casos el recubrimiento fue completo, presentando quistes subepiteliales difusos (tipo quístico). Dos casos mostraron una retracción conjuntival completa, sin cobertura por Tenon. Las paredes estaban adelgazadas, mostrando una desestructuración de la ampolla (patrón difuso). En un tercer grupo, la imagen obtenida mostraba una retracción conjuntival parcial con cobertura por Tenon. Presentaba algún quiste subepitelial difuso y con paredes siguiendo un patrón laminar.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Mediante la OCT-SA es posible estudiar de forma detallada las características de la ampolla y las de su cobertura en el caso de reparación con avance conjuntival por Seidel tardío. Permite visualizar precozmente la retracción de la conjuntiva que en la lámpara de hendidura no sería visible y predecir mediante la morfología de la ampolla la funcionalidad de la misma.</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: Cerdà-Ibáñez M, Pérez-Torregrosa VT, Olate-Pérez A, Almor Palacios I, Gargallo-Benedicto A, Osorio-Alayo V, et al. Análisis cualitativo de ampollas de filtración reparadas mediante tomografía de coherencia óptica de segmento anterior. Arch Soc Esp Oftalmol. 2017;92:359–365.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">This paper will be presented as a free communication at the 92nd Congress of the Ophthalmology Society of Spain (SEO), Malaga (Spain).</p>" ] ] "multimedia" => array:6 [ 0 => 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>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1379 "Ancho" => 1867 "Tamanyo" => 354628 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">(A) Conjunctival retraction and reappearance of active leak. (B) Thinned walls with large spaces. High reflectiveness in walls. (C) Level where study was carried out. It must be in the middle third of the scanner. (D) Destructured bleb with pathway under the sclera.</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" => 1225 "Ancho" => 1633 "Tamanyo" => 128153 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">(A) Multilayer type pattern. (B and C) The bleb is only covered by Tenon, preserving uniform reflectiveness. Multilayer pattern with some cysts.</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" => 1225 "Ancho" => 1633 "Tamanyo" => 283511 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The same bleb, exhibiting cystic pattern. Covering is complete, without destructuring of lead or thinned walls.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">CD: choroidal detachment; PT: phacotrabeculectomy.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Subjects \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Age \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Eye \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Previous surgery (year and procedure) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Time to Seidel \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ocular pressure at Seidel \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Associated complications \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2002: PT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin 0.04% 4<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 years<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2013: trabeculectomy<br>Mitomycin 0.01% during 1<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 years<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>4 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Choroidal detachment \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2005: PT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin 0.02% during 3<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Endophthalmitis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2000: trabeculectomy<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin 0.04% during 5<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 years<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>7 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2011: trabeculectomy<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin 0.01% during 2<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 years<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>10 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Choroidal detachment \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2001: PT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin 0.04% during 5<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Blebitis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2006: trabeculectomy<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin<span class="elsevierStyleHsp" style=""></span>C (0.02% 2<span class="elsevierStyleHsp" style=""></span>min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 years<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>11 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2010: PT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin<span class="elsevierStyleHsp" style=""></span>C 0.02% during 3<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 years<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 mes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2003: PT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin<span class="elsevierStyleHsp" style=""></span>C 0.04% during 5<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 years<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>10 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2002: trabeculectomy<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>mitomycin<span class="elsevierStyleHsp" style=""></span>C 0.04% during 4<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1474115.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Demographic data of patients included in the study.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Only three patients exhibited at month 6 the need to administer associated hypotensive treatment (column 3).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Subjects \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Immediate postop pressure \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Repair failure \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IOP at 6 months or after Seidel reappearance \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pattern and coverage with OCT-SA Triton (Topcon<span class="elsevierStyleSup">®</span>) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diffuses/competes conjunctival retraction \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cystic/complete conjunctival covering \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Laminar/covering only through Tenon \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cystic/complete conjunctival covering \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cystic/complete conjunctival covering \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cystic/complete conjunctival covering \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cystic/complete conjunctival covering \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cystic/complete conjunctival covering \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cystic/complete conjunctival covering \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Diffuse/complete conjunctival retraction \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1474116.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Results after bleb repair.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The surgical management of leaking filtering blebs" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.E. Loane" 1 => "A.G. Galanopoulos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Curr Opin Ophthalmol" "fecha" => "1999" "volumen" => "10" "paginaInicial" => "121" "paginaFinal" => "125" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10537762" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Late onset bleb leaks after glaucoma filtering surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.S. Greenfield" 1 => "J.M. Liebmann" 2 => "J. Jee" 3 => "R. Ritch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Ophthalmol" "fecha" => "1998" "volumen" => "116" "paginaInicial" => "443" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9565040" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0060" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combined cataract and glaucom surgery with mytomicin C: phacoemulsification-trabeculectomy compared to facoemulsification-deep slerectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.L. Funell" 1 => "M. Clowes" 2 => "N. Arand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bjo.2004.055319" "Revista" => array:6 [ "tituloSerie" => "Br J Ophthalmol" "fecha" => "2005" "volumen" => "89" "paginaInicial" => "694" "paginaFinal" => "698" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15923504" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0065" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complicaciones tardías relacionadas con la ampolla: blebitis y endoftalmitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Rebolleda" 1 => "F.J. Muñoz Negrete" 2 => "C. Cabarga" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Catarata y glaucoma" "paginaInicial" => "549" "paginaFinal" => "553" "serieFecha" => "2012" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0070" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stratus optical coherence tomography study of filtering blebs after primary trabeculectomy with a fornix-based conjunctival flap" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Hirooka" 1 => "M. Takagishi" 2 => "T. Baba" 3 => "H. Takenaka" 4 => "F. Shiraga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1755-3768.2008.01401.x" "Revista" => array:6 [ "tituloSerie" => "Acta Ophthalmol" "fecha" => "2010" "volumen" => "88" "paginaInicial" => "60" "paginaFinal" => "64" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19021595" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0075" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Filtering blebs imaging by optical coherence tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Savini" 1 => "M. Zanini" 2 => "P. Barboni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1442-9071.2005.01066.x" "Revista" => array:6 [ "tituloSerie" => "Clin Experiment Ophthalmol" "fecha" => "2005" "volumen" => "33" "paginaInicial" => "483" "paginaFinal" => "489" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16181273" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0080" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stratus OCT of filtering bleb after trabeculectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Babighian" 1 => "E. Rapizzi" 2 => "A. Galan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0420.2006.00616.x" "Revista" => array:6 [ "tituloSerie" => "Acta Ophthalmol Scand" "fecha" => "2006" "volumen" => "84" "paginaInicial" => "270" "paginaFinal" => "271" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16637853" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0085" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of trabeculectomy blebs using anterior segment optical coherence tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Singh" 1 => "P.T. Chew" 2 => "D.S. Friedman" 3 => "W.P. Nolan" 4 => "J.L. See" 5 => "S.D. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ophtha.2006.05.078" "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "2007" "volumen" => "114" "paginaInicial" => "47" "paginaFinal" => "53" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17070581" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0090" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anterior segment optical coherence tomography imaging of conjuctival filtering blebs after glaucoma surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Mastropasqua" 1 => "V. Fasanella" 2 => "L. Agnifili" 3 => "C. Crucio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2014/610623" "Revista" => array:5 [ "tituloSerie" => "BioMed Res Int" "fecha" => "2014" "volumen" => "2014" "paginaInicial" => "610623" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25136603" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009200000008/v1_201707250047/S2173579417300749/v1_201707250047/en/main.assets" "Apartado" => array:4 [ "identificador" => "5816" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009200000008/v1_201707250047/S2173579417300749/v1_201707250047/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300749?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2020 September | 0 | 1 | 1 |
| 2018 February | 3 | 1 | 4 |
