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Conjunctival autologous graft safe, effective for bleb revision

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GIZA, Egypt — Free conjunctival autologous graft is a safe and successful procedure for bleb repair and bleb reduction, according to a small study. However, patients should be made aware of the possibility of elevated postop IOP requiring medical or surgical intervention, the study authors said.

Researchers here conducted a retrospective review of 16 patients who underwent excisional revision of a filtering bleb. The revision consisted of bleb excision and free conjunctival autologous graft.

Nine of the patients had undergone trabeculectomy and seven had undergone deep sclerectomy with an implant. Bleb revision was necessary in 14 patients because of leaking filtering bleb and in two patients because of bleb dysesthesia.

After an average follow-up of 15 months, the mean IOP rose from 7.8 mm Hg to 14.3 mm Hg (P = .008). The qualified success rate was 83.3%. Four patients required additional suturing for persistent bleb leak. Six patients needed antiglaucomatous medical therapy to control elevated IOP, and one patient required repeated glaucoma surgery.

The study is published in the February issue of Journal of Glaucoma.