Bleb resuscitation of failing, leaking and dysfunctional blebs: A review
The success of trabeculectomy surgery depends on the longevity of the filtering bleb. Bleb failure can be categorized into two types: the scarred bleb with high intraocular pressure or the over-filtering and leaking bleb with low intraocular pressure. Bleb scarring is an insidious process over time...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-03-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/IJO.IJO_1233_24 |
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| Summary: | The success of trabeculectomy surgery depends on the longevity of the filtering bleb. Bleb failure can be categorized into two types: the scarred bleb with high intraocular pressure or the over-filtering and leaking bleb with low intraocular pressure. Bleb scarring is an insidious process over time as a consequence of excessive subconjunctival fibrosis. Timely recognition and early intervention utilizing a stepped-up approach are important for resuscitating the bleb and salvaging the trabeculectomy. Over-filtration and leaky bleb on the other end of the spectrum lead to failure of optimal bleb function and require a different management approach. This review discusses in detail various surgical techniques to revive dysfunctional blebs with a special focus on bleb needling. Timely identification and multifaceted management of bleb-related complications is the key to ultimately improving long-term success rates and patient outcomes. |
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| ISSN: | 0301-4738 1998-3689 |