Abstract: Objective To observe the one-year changes of filtering bleb configuration with photographs of slit-lamp microscopy after trabeculectomy. Design Prospective case series. Participants Five patients with thin-wall bleb and five patients with thick-wall bleb were included. Methods The configuration of filtering bleb on photographs of slit-lamp microscopy were compared and analyzed with Photoshop software at 1~2, 3 weeks, 1, 3, 6 and 12 months after trabeculectomy.  Main Outcome Measures The area of the bleb, the distance between the upper edge of the bleb and the corneal limbus, the distance between the lower edge of the bleb and the corneal limbus, the height of the bleb and Shield’s test. Results In the thin-wall bleb group, at 3 week after the trabeculectomy, the distance between the lower edge of the bleb and the corneal limbus shortened significantly than that at 1~2 weeks after the surgery(P=0.042). The area of bleb decreased (P=0.043). There is no pale area in the bleb. At 1 month after trabeculectomy, the area of bleb decreased significantly (P=0.043), as well as the height of the bleb (P=0.042). The pale area increased. At 3 month after trabeculectomy, the pale area increased. Most vessels anastomosed around the margin of the bleb. The wall of the bleb thinned. No significant changes happened at 6 and 12 months after trabeculectomy. In thick-wall bleb group, after 3 weeks, the distance between the upper edge of the bleb and the corneal limbus shortened significantly (P=0.043) and the area of bleb decreased (P=0.043). Small pale area emerged. After 1 month, the distance between the upper edge of the bleb and the corneal limbus shortened significantly (P=0.042). The area of bleb decreased (P=0.043). Vessels around the bleb were dendrimer. No significant changes happened at 3, 6, 12 months after trabeculectomy. Conclusion In the 3 months after trabeculectomy, the bleb configuration changed dramatically. The lower edge of the thin-wall bleb invaded into the corneal limbus. After 3 months, the pale area of the thin-wall bleb enlarged and the wall thinned further. But the configuration of the thick-wall bleb changed little. (Ophthalmol CHN, 2014, 23: 31-36)

Key words: glaucoma/surgery, thin-wall bleb, thick-wall bleb