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Bleb leakage more common at long term after mitomycin trab

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TOKYO — Bleb leakage was more likely to occur in blebs of long duration after trabeculectomy with mitomycin-C, according to a study in Japanese eyes. Blebs with large avascular areas were also associated with a higher risk of leakage in the study.

Ophthalmologists should be aware of the possibility of bleb leakage induced by digital ocular pressure, especially for blebs with a long postoperative duration, the study authors note.

Chao-Yu Hu, MD, and colleagues at the University of Tokyo School of Medicine and elsewhere examined 162 eyes of 162 patients with glaucoma who had undergone primary trabeculectomy with mitomycin-C. All eyes had functioning blebs postoperatively.

Among different types of primary glaucoma, no differences were seen in bleb characteristics. With long postoperative duration, the blebs tended to be thinner. With digital ocular pressure, the leakage rate increased from 3.1% to 5.6% and the oozing rate increased from 11.1% to 35.8%. The larger the avascular area, the more likely the bleb was to leak without digital ocular pressure.

The study is published in the February issue of Ophthalmology.