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Management of encapsulated filtration blebs
B J Shingleton1, C U Richter, A R Bellows
1Glaucoma Service, Ophthalmic Consultants of Boston, Inc., MA 02114.
Ophthalmology
|January 1, 1990
Summary
Encapsulated filtration blebs can cause temporary intraocular pressure (IOP) spikes after glaucoma surgery. Vigorous medical therapy, including drops and massage, is crucial in the first two months to manage IOP and prevent further surgical intervention.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Ocular Hypertension
Background:
- Encapsulated filtration blebs are a known complication following glaucoma surgery.
- Elevated intraocular pressure (IOP) in these blebs can compromise surgical success.
Purpose of the Study:
- To evaluate the trend of intraocular pressure (IOP) in encapsulated filtration blebs.
- To assess the efficacy of medical and surgical interventions for managing IOP in these cases.
Main Methods:
- A retrospective study of 49 eyes with encapsulated filtration blebs.
- Follow-up ranged from 6 to 48 months, with IOP measurements recorded postoperatively.
Main Results:
- IOP peaked at 3 weeks post-surgery (26.1 mmHg) before decreasing to a stable level (16.2 mmHg at 16 weeks).
- 39 eyes achieved a final IOP of 19 mmHg or less.
- 14 eyes required surgical reintervention for uncontrolled IOP elevation.
Conclusions:
- Encapsulated blebs can cause transient IOP elevation, necessitating close monitoring and management.
- Aggressive medical therapy, including glaucoma medications and digital massage, is vital in the initial postoperative period.
- IOP often stabilizes after 2 months, potentially avoiding the need for repeat surgery.