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Management of bleb complications after trabeculectomy
Dexter Y L Leung1, Clement C Y Tham
1Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, The People's Republic of China. dexleung@alumni.cuhk.net
Abstract:
Trabeculectomy remains a mainstay surgery for glaucoma. The necessity to raise a bleb and use of chemoadjuvants may result in bleb-related complications, such as bleb-fibrosis, bleb-leaks, bleb-related infections, overfiltration, or hypotony. This review highlights some of the latest developments in preventing and managing these complications, including anti-vascular endothelial growth factors, monoclonal antibodies for moderate reduction of fibrosis, newer surgical strategies for bleb leaks, an update from a randomized clinical trial highlighting the incidence and management of bleb-related infections, and various treatment strategies for an overfiltering bleb. In addition, other surgical interventions with less or no bleb-related complications will be discussed, including non-penetrating glaucoma surgeries, glaucoma drainage devices, or phacoemulsification.
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