Intrableb pigmentation a good sign after filtration surgery

Intrableb pigmentation may be a positive sign in bleb filtration surgery, said Boonsong Wanichwecharungruang, MD, fromRajavithi Hospital, Bangkok, Thailand.

Dr. Wanichwecharungruang divided the pigmentation based on the degree from mild to very dark, almost black.

When he and his colleagues compared the results from 44 cases with intrableb pigmentation versus 40 controls withoutpigmentation, they found that the complete success rate was better in the group with intrableb pigmentation after a follow-upof about 2 years.

"Intrableb pigmentation was associated with thin and cystic blebs," he said. The overall success, the mean IOP, and the meanreduction in the number of postoperative glaucoma medications were not significant but were better in the group withintrableb pigmentation.

Intrableb pigmentation, which originates from uveal melanocytes, is associated with a thin-walled bleb, which in turn allowsbetter flow of aqueous humor and better detection of pigmentation, he explained.

"Intrableb pigmentation presents as a tracer element of aqueous flow from the anterior chamber to the filtering bleb," Dr.Wanichwecharungruang said. "The pigmentation appears to be a favorable sign of filtering surgery, but a much larger samplesize and longer follow-up are needed."