Surgical Results of Bleb Revision With Scleral Patch Graft for Late-Onset Bleb Complications

Abstract

<div class="ftSection"><span class="ftInlineSubsectionTitle">BACKGROUND AND OBJECTIVE:</span><p> To describe the results of bleb revision with scleral patch graft for late-onset bleb-related complications.</p></div><div class="ftSection"><span class="ftInlineSubsectionTitle">PATIENTS AND METHODS:</span><p> A retrospective case series between October 1996 and March 2003.</p></div><div class="ftSection"><span class="ftInlineSubsectionTitle">RESULTS:</span><p>Fourteen patients had surgery for bleb leak, hypotonous maculopathy, dysesthesia, or bleb-associated infections after initial trabeculectomy or thermal sclerostomy. The preoperative intraocular pressure was 3.3 ± 2.6 mm Hg, and the final intraocular pressure was 11.6 ± 3.4 mm Hg after 10.1 ± 6.8 months. Seven eyes required no further bleb revision or glaucoma medications. Visual acuity improved in 10 of 14 eyes. A second scleral patch graft revision was necessary in 3 eyes, but bleb leaks and hypotony resolved in all 14 eyes at last follow-up. Complications included bleb failure, bullous keratopathy progression, cataract progression, and ptosis.</p></div><div class="ftSection"><span class="ftInlineSubsectionTitle">CONCLUSION:</span><p>Bleb revision with scleral patch graft is effective for treating late-onset bleb complications, resulting in improvement in visual acuity and resolution of hypotonous maculopathy, bleb leaks, and dysesthesia.</p><p><b>[Ophthalmic Surg Lasers Imaging 2005;36:14–23.]</b></p></div>