Bleb Revision for Resolution of Hypotony Maculopathy Following Primary Trabeculectomy

Abstract

We read with great interest the recent article by Bitrian and associates 1 Bitrian E. Song B.J. Caprioli J. Bleb revision for resolution of hypotony maculopathy following primary trabeculectomy. Am J Ophthalmol. 2014; 158: 597-604 Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar in which they retrospectively reviewed 33 eyes with hypotony maculopathy before and after surgical bleb revision. Using different surgical techniques for bleb repair (compressive sutures, scleral flap suturing, or scleral patch grafting), they obtained a significant improvement in visual acuity (VA) (from logMAR VA 0.78 to logMAR 0.45 at 12 months), good intraocular pressure (IOP) control (from 3.51 to 12.06 mm Hg) with glaucoma drops in 48% of the patients, and a 15% re-revision rate to correct persistent hypotony. Bleb Revision for Resolution of Hypotony Maculopathy Following Primary TrabeculectomyAmerican Journal of OphthalmologyVol. 158Issue 3PreviewTo describe a surgical method of bleb revision for hypotony maculopathy, to evaluate its long-term efficacy, and to define the relationship between the duration of hypotony maculopathy and visual acuity (VA) outcomes. Full-Text PDF ReplyAmerican Journal of OphthalmologyVol. 159Issue 2PreviewWe appreciate the interest and comments from Dr Pazos and colleagues about our recent manuscript. We agree that excision of old, avascular conjunctiva is a necessary step toward a successful surgical outcome, although our preference is to use a patch graft, such as pericardium or donor sclera, only when additional reinforcement is needed to restrict aqueous outflow. Full-Text PDF