Bleb needling with subconjunctival ologen insertion using IOL cartridge.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Wound Healing Modulation

Background:

• Failing filtration blebs after trabeculectomy lead to elevated intraocular pressure (IOP).
• Standard bleb needling may not sufficiently restore bleb function.
• Modulating wound healing is crucial for long-term surgical success in glaucoma management.

Observation:

• A novel technique involved bleb needling followed by subconjunctival injection of a biodegradable collagen implant (Ologen) using an intraocular lens (IOL) delivery system.
• This procedure was performed on two eyes with failing filters and high IOP.
• The technique utilized a 26G needle for needling and an IOL injector system with a cartridge for implant delivery.

Findings:

• Postoperatively, the filtration blebs were diffusely elevated.
• Intraocular pressure (IOP) was successfully maintained between 10 and 14 mmHg.
• These IOP levels were sustained at 6 weeks, 3 months, and 6 months post-procedure.

Implications:

• Bleb needling augmented with a biodegradable collagen implant delivered via an IOL injector is a viable option for managing failing filters post-trabeculectomy.
• This technique offers a potentially improved approach to restoring bleb function and controlling IOP in refractory glaucoma cases.
• Further studies are warranted to confirm the long-term efficacy and safety of this augmented bleb needling technique.