Management of leaking filtration blebs

This study describes 11 patients, in whom filtering surgery was performed, who developed a leaking filtration bleb postoperatively. Average follow-up time was 3 1/2 years. In three patients, suturing of the conjunctiva was performed. In two, anterior chamber reformation and choroidal tap were required, and, in both cases, the leak sealed spontaneously without surgical repair. In two, the glaucoma shell tamponade technique was used to facilitate anterior chamber reformation. These reformed in both cases, and no subsequent shallow anterior chambers have been noted. In four cases, conservative therapy, which consisted of antibiotics, glaucoma medication with or without patching, and careful patient observation, was used to manage the leaking blebs. Complications observed were: iritis (1 case), early infection of the bleb (1), flat anterior chamber (1), and failure of the bleb to allow sufficient aqueous humor outflow (2).