[Treatment of late leaking of filtering bullae]

Leaking filtering blebs must be repaired immediately to avoid major complications such as hypotony and endophtalmitis. We report four cases of leaking filtering blebs occurring between one to six years after trabeculectomy. Revealing signs were hypotony in two cases and athalamia in two cases. Patching was done in one case and conjunctival reinforcement by rotation of conjunctival flap in 2 cases and free conjunctival graft in one case. Leaking disappeared in all the cases. Normal intraocular pressure (10-12 mmHg) was obtained in all cases except one which was achieved by rotation of conjunctival flap and complicated by retraction of conjunctiva. Conjunctival reinforcement without exicion of the bleb is an easy technique and respect the filtration site. Major complication in our patients is retraction of conjunctival flap which can be avoided by: exicion of Tenon, good fixation to the cornea, and free conjunctival graft.