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BACKGROUND AND OBJECTIVE: To describe the results of bleb revision with scleral patch graft for late-onset bleb-related complications. PATIENTS AND METHODS: A retrospective case series between October 1996 and March 2003. RESULTS: Fourteen patients had surgery for bleb leak, hypotonous maculopathy, dysesthesia, or bleb-associated infections after initial trabeculectomy or thermal sclerostomy. The preoperative intraocular pressure was3.3± 2.6 mm Hg, and the final intraocular pressure was 11.6± 3.4 mm Hg after 10.1± 6.8 months. Seven eyes required no further bleb revision or glaucoma smedications. Visual acuity improved in 10 of 14 eyes. A second scleral patch graft revision was necessary in3 eyes, but bleb leaks and hypotony resolved in all 14 eyes at last follow-up. Complications included bleb failure, bullous keratopathy progression, cataract progression, and ptosis. CONCLUSION: Bleb revision with scleral patch graft is effective for treating late-onset bleb complications, resulting in improvement in visual acuity and resolution of hypotonous maculopathy, bleb leaks, and dysesthesia.
BACKGROUND AND OBJECTIVE: To describe the results of bleb revision with scleral patch graft for late-onset bleb-related complications. PATIENTS AND METHODS: A retrospective case series between October 1996 and March 2003. RESULTS: Fourteen patients had surgery for bleb leak, hypotonous maculopathy, dysesthesia, or bleb-associated infections after initial trabeculectomy or thermal sclerostomy. The preoperative intraocular pressure was 3.3 ± 2.6 mm Hg, and the final intraocular pressure was 11.6 ± 3.4 mm Hg after 10.1 ± 6.8 months. Seven eyes required no further Visual acuity improved in 10 of 14 eyes. A second scleral patch graft revision was necessary in 3 eyes, but bleb leaks and hypotony resolved in all 14 eyes at last follow-up. Complications included bleb failure, bullous keratopathy progression , cataract progression, and ptosis. CONCLUSION: Bleb revision with scleral patch graft is effective for treating late-onset bleb complications, resultin g in improvement in visual acuity and resolution of hypotonous maculopathy, bleb leaks, and dysesthesia.