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.
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.
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.
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.
Wise JB. Treatment of chronic postfiltration hypotony by intrableb injection of autologous blood. Arch Ophthalmol 1993 Jun;111(6):827-830.
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.
Gehring JR, Ciccarelli EC. Trichloroacetic acid treatment of filtering blebs following cataract extraction. Am J Ophthalmol 1972 Oct;74(4):622-624.
Hennis HL, Stewart WC. Use of the argon laser to close filtering bleb sleaks. Graefes Arch Clin Exp Ophthalmol 1992;230(6):537-541.
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.
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.
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.
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.
Zacharia PT, Deppermann SR, Schuman JS. Ocular hypotony after trabeculectomy with mitomycin C. Am J Ophthalmol 1993 Sep;116(3):314-326.
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.
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.
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.
La Borwit SE, Quigley HA, Jampel HD. Bleb reduction and bleb repair after trabeculectomy. Ophthalmology 2000 Apr;107(4):712-718.
