Anterior Segment Optical Coherence Tomography and Anterior Segment Optical Coherence Tomography Angiography After Bleb Forming Glaucoma Surgeries: A Systematic Review

Background: The bleb-forming surgical spectrum in open-angle glaucoma has recently been expanded by novel surgical approaches. Through a medical device implantation (Xen Gel Stent (XGI) or Preserflo Microshunt (PMI)), these procedures aim at more standardised aqueous humour shunting and an intra- and postoperative risk reduction. Postoperatively, however, XEN, PMI and trabeculectomy share their dependence on the proper function of the filtration bleb. This review summarises available literature on anterior segment optical coherence tomography (AS-OCT)- and AS-OCT angiography (AS-OCTA)-based bleb parameters with an emphasis on their association with bleb function.

Methods: A systematic PubMed search was performed to identify the available evidence.

Results: A total of 52 suitable reports were identified and are presented in a structured manner.

Conclusion: The retrieved literature demonstrates that there exists a broad body of evidence for the use of AS-OCT and AS-OCTA after TE, XGI and PMI with the potential for AS-OCT and AS-OCTA enhanced follow-up plans. Their implementation in clinical routine is, however, currently impaired by highly variable and impractical study endpoints, lacking transferability of available evidence between different surgical procedures and missing evidence from prospective interventional trials.