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[A case of encapsulated filtering bleb after trabeculectomy]
H Watanabe1, T Yamada, M Tamai
1Department of Ophthalmology, Tohoku University School of Medicine, Miyagi-ken, Japan.
Nippon Ganka Gakkai Zasshi
|October 1, 1995
Summary
Encapsulated filtering blebs can complicate glaucoma surgery. This case highlights the challenges in managing these cysts, emphasizing the need for vigilance after trabeculectomy and laser therapy.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Ocular Inflammation
Background:
- Trabeculectomy is a common surgical procedure for managing primary open-angle glaucoma.
- Post-surgical complications, such as encapsulated filtering blebs, can compromise surgical outcomes.
- Laser therapy to the anterior chamber angle may influence bleb morphology and function.
Observation:
- A 57-year-old male developed a shrinking filtering bleb and rising intraocular pressure (IOP) six months after trabeculectomy.
- Initial intervention with Nd:YAG laser sclerostomy ab interno failed to resolve the issue, leading to increased IOP and inflammation.
- Subsequent trabeculectomy in a new site resulted in a prominent, dome-shaped bleb, diagnosed as an encapsulated filtering bleb (Tenon's capsule cyst).
Findings:
- Encapsulated filtering blebs represent a significant post-trabeculectomy complication.
- Cystectomy proved ineffective, with recurrence of the encapsulated bleb.
- Additional trabeculectomy was required to achieve reasonable IOP control.
Implications:
- Encapsulated filtering blebs should be recognized as a potential complication following glaucoma filtering surgery, especially after laser interventions.
- Management requires careful consideration, as initial interventions may be unsuccessful.
- Further surgical procedures may be necessary to restore adequate IOP control and bleb function.