Original ArticleComparison of Two Clinical Bleb Grading Systems
Section snippets
Patients and Blebs
Sequential patients with filtering blebs were recruited from the glaucoma service outpatient department at the glaucoma clinic, Wellington Hospital. Local Ethics Committee approval was granted and all patients gave informed consent for clinical grading at the slit lamp of their bleb appearances.
A prospective interobserver and intermethod agreement study of 24 blebs of 17 consecutive patients that had previous glaucoma surgery was conducted, with grading at the slit lamp conducted independently
Bleb Characteristics
Twenty-four blebs of 17 consecutive patients were graded, with a bleb age range of 1 week to 12 years after surgery. Seventeen blebs were treated with adjunctive mitomycin C at the time of surgery, 3 blebs had 5-fluorouracil, 2 blebs had no antimetabolite, and the remaining 2 blebs did not have details of adjunctive treatment available.
Although the study group was a representative group of consecutive patients from a glaucoma clinic, a reasonably wide variety of bleb types and range of
Discussion
Both of the bleb grading systems performed adequately. The IBAGS was easier to use and performed very well for variability, but had relatively few steps (3- to 4-point scale for most parameters) and may have reduced fidelity as a result. The MBGS was more complex and generally had more steps in the grading scale. Variability was comparable, despite the increased scale of possible values in the MBGS. All graders were inclined to grade avascularity as a score of 0, as in the IBAGS. There was some
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Manuscript no. 2005-390.
Supported by a grant from the Capital Vision Research Trust, Wellington, New Zealand.
The authors have no financial interests in the article.