Intraoperative Healon5 injection into blebs for small conjunctival breaks created during trabeculectomy

Leakage from a conjunctival break created during trabeculectomy may cause serious complications such as shallow anterior chamber, hypotony, and a flat bleb in the early postoperative period. Therefore, careful handling of the conjunctiva with a nontoothed forceps is essential. However, thin conjunctiva is susceptible to mechanical injury and is difficult to repair with suturing, especially when the point of leakage is close to the scleral flap. In 3 consecutive cases in which a small break in the thin conjunctiva adjacent to the scleral flap was created during trabeculectomy, sodium hyaluronate 2.3% (Healon5) was intraoperatively injected into the bleb. The break was successfully closed with an intraoperative injection of Healon5 into the bleb. This procedure appears to be a simple, safe, and effective method for closure of a small conjunctival break.