advertisement
Abstract #5513 Published in IGR 1-2
Surgical management of the symptomatic overhanding filtering bleb
Lanzl IM; Katz J; Shindler RL; Spaeth GLJournal of Glaucoma 1999; 8: 247-249
PURPOSE: Large filtering blebs that evolve after trabeculectomies can be bothersome to the patient, especially when overhanging the cornea. Partial bleb excision is warranted to relieve the patient of discomfort or even visual impairment. METHODS: Surgical partial excision of the overhanging corneal part of the bleb was performed in four patients who had undergone earlier trabeculectomy without application of antimetabolites. Duration of follow-up after excision ranged from 9 months to 4 years. RESULTS: Successful reduction of the excessive bleb and continued satisfactory control of intraocular pressure (IOP) were achieved in all four cases. Partial excision of the corneal part of the bleb did not lead to bleb leakage in any of the cases. CONCLUSION: Surgical blunt dissection of the overhanging part of the exuberant bleb seems to be a potential method of successfully rearranging the morphologic features of the bleb and ensuring continued control of IOP and relief of symptoms. Alternative methods, such as autologous blood injection, cryoapplication, application of trichloroacetic acid, or application of Nd:YAG laser, are noninvasive but do not allow precise rearrangement of bleb architecture.
I.M. Lanzl, Ismaninger Strasse 22, 81675 Munich; Germany
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
