Filtering bleb revision. Techniques and outcome

Background. The surgical management and outcome of bleb-related complications such as leaking blebs, overfiltration and blebitis are reported. Methods. A retrospective analysis was carried out of 35 patients who underwent surgical repair of the filtering bleb in our hospital between 1991 and 2000. Results. Surgical techniques used were autologous blood injection, fibrin glue injection, conjunctival suturing, resuturing of the trabeculectomy flap, bleb excision, conjunctival advancement, lyodura and tenon patching. In the eyes with leaking blebs the mean preoperative intraocular pressure (IOP) was 11.6 +/- 10.3 mmHg. After an average follow-up of 12 months the 1013 was 11.9 +/- 3.3 mmHg. In the eyes with overfiltration the mean IN was 2.4 +/- 1.5 mmHg and after an average follow-up of 18 months the mean IOP increased to 13.5 +/- 3.7 mmHg. In 77.1% the IOP was regulated between 8 and 21 mmHg without glaucoma medication. Mean visual acuity improved by 3.6 +/- 5.9 lines postoperatively. Conclusion. Surgical bleb revision has a high success rate with regard to maintaining a functioning filtering bleb and to preserving vision.