Inadvertent filtering bleb following sutureless cataract surgery

Area of Science:

• Ophthalmology
• Surgical Techniques
• Ophthalmic Surgery

Background:

• Cataract surgery can lead to complications, including the formation of filtering blebs.
• Post-surgical filtering blebs, especially those with internal leakage, require prompt diagnosis and management.
• Ophthalmic surgeons must be vigilant for wound integrity issues after intraocular procedures.

Observation:

• A 62-year-old female patient developed a bleb in her left eye post-cataract surgery.
• Gonioscopy revealed fishmouthing of the internal scleral tunnel incision, indicating an internal leak.
• The patient had no prior history of glaucoma surgery.

Findings:

• The diagnosis of a post-cataract filtering bleb was established.
• Management involved resuturing the scleral tunnel incision to address the internal leak.
• Horizontal mattress sutures were utilized for wound closure.

Implications:

• This case underscores the utility of gonioscopy in evaluating internal wound integrity after cataract surgery.
• Intraoperative recognition and repair of internal leaks are crucial for preventing filtering blebs.
• Effective management of such complications can improve patient outcomes and reduce the need for further interventions.