*Article* **Influence of Overhanging Bleb on Corneal Higher-Order Aberrations after Trabeculectomy**

**Yu Mizuno \*, Kazuyuki Hirooka and Yoshiaki Kiuchi**

Department of Ophthalmology and Visual Science, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima 734-8551, Japan; kazuyk@hiroshima-u.ac.jp (K.H.); ykiuchi@hiroshima-u.ac.jp (Y.K.) **\*** Correspondence: ymizuno@hiroshima-u.ac.jp; Tel.: +81-82-257-5247

**Abstract:** Recent advances in ocular aberrometry have revealed that ocular surgery increases ocular and corneal higher-order aberrations. This retrospective single-center study aimed to examine the effects of the overhanging bleb on corneal higher-order aberrations using a wavefront analyzer. We included 61 eyes from 50 patients with overhanging bleb after trabeculectomy with a fornixbased conjunctival flap using mitomycin C (overhanging bleb group) and 65 eyes from 54 glaucoma patients with no history of glaucoma surgery (control group). Corneal higher-order aberrations (total higher-order aberrations, coma aberrations, coma-like aberrations, spherical aberrations, and spherical-like aberrations) on a 4 mm pupil diameter were measured using the TOPCON KR-1W wavefront analyzer. Corneal coma aberrations were higher in the overhanging bleb group than in the control group (0.16 ± 0.13 μm and 0.10 ± 0.05 μm, respectively; *p* = 0.042). Corneal coma-like aberrations were also higher in the overhanging bleb group than in the control group (0.31 ± 0.32 μm and 0.16 ± 0.09 μm, respectively; *p* = 0.022). With an increasing ratio of cornea covered by the bleb to the entire cornea, all corneal higher-order aberrations increased except for corneal coma-like aberrations. Overhanging bleb after trabeculectomy with a fornix-based conjunctival flap using mitomycin C and its size influenced corneal higher-order aberrations.

**Keywords:** glaucoma; overhanging bleb; higher-order aberrations; trabeculectomy; mitomycin C
