Journal of Current Glaucoma Practice

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VOLUME 6 , ISSUE 2 ( May-August, 2012 ) > List of Articles


Bleb Revision using Reversed Scleral Flap and Pedical Conjunctival Graft

Sourabh Sharma, Dhaval Patel, Reetika Sharma

Keywords : Bleb, Conjunctival graft, Hypotony, Trabeculectomy

Citation Information : Sharma S, Patel D, Sharma R. Bleb Revision using Reversed Scleral Flap and Pedical Conjunctival Graft. J Curr Glaucoma Pract 2012; 6 (2):94-97.

DOI: 10.5005/jp-journals-10008-1113

License: CC BY-NC 4.0

Published Online: 01-04-2018

Copyright Statement:  Copyright © 2012; The Author(s).


Bleb revision for hypotony maculopathy following trabeculectomy is an effective technique for raising intraocular pressure and limiting visual loss. The presence for scleral fistula causing over-filtration obviates the need for reinforcing materials, such as donor sclera or pericardium to cover the defect. However, if the surrounding scleral tissue is healthy, a partial thickness scleral flap can be upturned and sutured over the fistula. Moreover, a vascularized pedical conjunctival graft can also be used in cases where there is a large conjunctival defect.

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  1. Azuara-Blanco A, Katz LJ. Dysfunctional filtering blebs. Surv Ophthalmol 1998 Sep-Oct;43(2):93-125.
  2. Blok MD, Kok JH, van Mil C, Greve EL, Kijlstra A. Use of the Megasoft bandage lens for treatment of complications after trabeculectomy. Am J Ophthalmol 1990 Sep;110(3):264-268.
  3. Nuyts RM, Greve EL, Geijssen HC, Langerhorst CT. Treatment of hypotonous maculopathy after trabeculectomy with mitomycin C. Am J Ophthalmol 1994 Sep;118(3):322-331.
  4. Choudhri SA, Herndon LW, Damji KF, Allingham RR, Shields MB. Efficacy of autologous blood injection for treating overfiltering or leaking blebs after glaucoma surgery. Am J Ophthalmol 1997 Apr;123(4):554-555.
  5. Wise JB. Treatment of chronic postfiltration hypotony by intrableb injection of autologous blood. Arch Ophthalmol 1993 Jun;111(6):827-830.
  6. Leen MM, Moster MR, Katz LJ, Terebuh AK, Schmidt CM, Spaeth GL. Management of overfiltering and leaking blebs with autologous blood injection. Arch Ophthalmol 1995 Aug;113(8):1050-1055.
  7. Gehring JR, Ciccarelli EC. Trichloroacetic acid treatment of filtering blebs following cataract extraction. Am J Ophthalmol 1972 Oct;74(4):622-624.
  8. Hennis HL, Stewart WC. Use of the argon laser to close filtering bleb sleaks. Graefes Arch Clin Exp Ophthalmol 1992;230(6):537-541.
  9. Akova YA, Dursun D, Aydin P, Akbatur H, Duman S. Management of hypotony maculopathy and a large filtering bleb after trabeculectomy with mitomycin C. Success with argon laser therapy. Ophthalmic Surg Lasers 2000 Nov-Dec;31(6):491-494.
  10. Zacchei AC, Palmberg PF, Mendosa A, Robinson JC. Compression sutures: A new treatment for leaking or painful filtering blebs. Invest Ophthalmol Vis Sci 1996;37(3):S444.
  11. Palmberg P. Late complications after glaucoma filtering surgery. In: Leader B, Calckwood J, editors. Proceedings of the 45th Annual Symposium of the New Orleans Academy of Ophthalmology. The Hague: Kugler Publications, 1996.
  12. Costa VP, Wilson RP, Moster MR, Schmidt CM, Gandham S. Hypotony maculopathy following the use of topical mitomycin C in glaucoma filtration surgery. Ophthalmic Surg 1993 Jun;24(6):389-394.
  13. Zacharia PT, Deppermann SR, Schuman JS. Ocular hypotony after trabeculectomy with mitomycin C. Am J Ophthalmol 1993 Sep;116(3):314-326.
  14. Suñer IJ, Greenfield DS, Miller MP, Nicolela MT, Palmberg PF. Hypotony maculopathy after filtering surgery with mitomycin C. Incident and treatment. Ophthalmology 1997 Feb;104(2):207- 215.
  15. Van de Geijn EJ, Lemij HG, de Vries J, de Waard PW. Surgical revision of filtration blebs: A follow-up study. J Glaucoma 2002 Aug;11(4):300-305.
  16. Cohen SM, Flynn HW, Palmberg PF, Gass JD, Grajewski AL, Parrish RK 2nd. Treatment of hypotony maculopathy after trabeculectomy. Ophthalmic Surg Lasers 1995 Sep- Oct;26(5):435-441.
  17. Catoira Y, Wudunn D, Cantor LB. Revision of dysfunctional filtering blebs by conjunctival advancement with bleb preservation. Am J Ophthalmol 2000 Nov;130(5):574-579.
  18. La Borwit SE, Quigley HA, Jampel HD. Bleb reduction and bleb repair after trabeculectomy. Ophthalmology 2000 Apr;107(4):712-718.
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