Surgical Treatment of a Leaking Glaucoma Filtering Bleb Case Report
Bencic G., Saric D., Korsic J., Mandic Z.
University Eye Clinic, University Hospital Zagreb/HR
Purpose: To report the surgical management of late onset bleb leak in a patient with persistent severe hypotony.
Method: Male, 64, underwent a full-thickness glaucoma filtering surgery for primary open angle glaucoma. Several months after the surgery he developed a bleb leak and hypotony maculopathy. Free conjunctival graft and amniotic membrane transplantation were used 2 times unsuccessfully in an attempt to repair the filtering bleb, before referring the patient to our Department. In this case we have performed the closure of the bleb leak with a partial thickness autologous scleral patch.
Results: After a 6 month follow-up the bleb remained leak free. Seidel test was negative. IOP increased from 4 mmHg to 12 mmHg. Hypotony maculopathy has resolved and visual acuity improved from 0.075 to 0.5 at most recent follow-up.
Conclusions: Late onset bleb leak is a potentially serious complication of glaucoma filtering surgery. The choice of surgical procedure is often not easy and in our case only after performing partial thickness scleral patch was bleb leak successfully repaired.
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