Clinicopathologic features and surgical management of dissecting glaucoma filtering blebs

Three patients are described in whom full-thickness glaucoma filtering procedures were complicated by marked extension of the bleb over the cornea, with subsequent symptoms that required surgical intervention. The surgical management in each case involved blunt dissection of the bleb from the cornea, with revision of the remaining portion of the bleb differing in each case according to the intraoperative findings. Light microscopic examination of one surgical specimen revealed a markedly attenuated epithelium covering hydropic corneal stroma. The authors postulate that the mechanism of formation involves aqueous humor dissection between corneal epithelium and stroma, leading to abnormal hydration of the superficial lamellae.