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Surgical revision of filtration blebs yields good results

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ROTTERDAM, Netherlands — A combination of bleb excision and advancement of conjunctiva and Tenon’s capsule gives patients with bleb complications satisfactory intraocular pressure control, according to results of a small study.

Researchers here conducted a retrospective analysis of 36 consecutive cases of leaking, overfiltering or oversized blebs. Surgical success was defined as an IOP between 6 mm Hg and 22 mm Hg with or without topical anti-glaucoma medication, resolution of bleb leak, hypotony maculopathy and symptoms and no need for repeat surgery.

The overall success rate was 86% after an average 29.5 months of follow-up, with 52% of patients not requiring medication. Mean IOP of the successful group was 23.7 mm Hg before surgery and 13.5 mm Hg at the last follow-up after the revision surgery. The mean number of antiglaucoma medications dropped from 2.1 before surgery to 0.8 after the surgery.

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