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Abstract #12180 Published in IGR 7-2
Sequential management of chronic leaking bleb
Euswas A; Warrasak S; Methasiri SAsian Journal of Ophthalmology 2005; 7: 26-29
AIM: To report the sequential management of late leaking filtering bleb that spontaneously occurred following trabeculectomy with mitomycin C or following trauma. PATIENTS AND METHODS: Seven eyes of 7 patients with late bleb leak who developed hypotony between January 2001 and June 2004 were included in this retrospective, non-comparative, interventional case series. Sequential management consisted of therapeutic contact lens, cyanoacrylate glue with overlying soft contact lens, dye-enhanced laser photocoagulation, horizontal purse-string compression suture, and bleb revision with transposition conjunctival graft. RESULTS: Preoperative intraocular pressure ranged from 0 to 5 mmHg. The leakage site was successfully closed in all 7 eyes. Five eyes were successfully treated with compression sutures, 1 with cyanoacrylate glue, and 1 with bleb revision using a transposition flap from the surrounding conjunctiva. The final intraocular pressure ranged from 10 to 18 mmHg. Four eyes gained at least 2 Snellen lines of visual acuity, 1 improved from hand movement to 20/400, 1 had stabilised vision, and 1 had decreased visual outcome. CONCLUSION: Sequential management ranging from non-invasive measures to compression suture and surgical revision with conjunctival graft was effective for closing most late bleb leaks and preserving some visual function, although intraocular pressure control was compromised.
Dr. A. Euswas, Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Rama 6 Rd., Rajthevi, Bangkok 10400, Thailand
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)