Acta clinica Croatica, Vol. 62. No. 2, 2023.
Recenzija, prikaz
https://doi.org/10.20471/acc.2023.62.02.18
Avascular Overhanging Bleb Reduction with Modified Sutureless Technique
Marta Pazos
; Institut Clínic d’Oftalmologia - Hospital Clínic i Provincial de Barcelona, Barcelona, Spain; Institut de la Mácula, Barcelona, Spain
Ana Martínez-Palmer
; Hospital del Mar i l’Esperança - Parc de Salut Mar, Barcelona, Spain; Institut Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain
Vladimir Poposki
; Hospital del Mar i l’Esperança - Parc de Salut Mar, Barcelona, Spain; Institut Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain
Sažetak
A late postoperative trabeculectomy complication could be the overhanging bleb,
especially when antimetabolites are used. It can be associated with hypotony, foreign body sensation,
dellen, and visual compromise. We report a case of an avascular overhanging bleb successfully reduced
with a modified sutureless technique. Nine years before, our patient had trabeculectomy using mitomycin
C. After the surgery, the intraocular pressure was correct, without progression in the visual
field, but on slit-lamp examination, a large avascular overhanging bleb was noted. Partial excision was
performed with dissection from the cornea, overhanging conjunctival trimming, leakage checking and
Bandage Contact lens placement. Topical antibiotic and steroid treatment was administered for three
weeks. The excised conjunctival histopathology showed avascular metaplastic epithelium. Six months
after the surgery, the patient’s visual acuity improved, with intraocular pressure of 12 mm Hg and a
Seidel negative asymptomatic bleb. In conclusion, this less invasive technique preserves better bleb
function without ripping the surrounding ischemic tissue. The procedure is safe and easy to perform,
with less surgical time and fast recovery.
Ključne riječi
Trabeculectomy; Overhanging bleb, avascular; Modified sutureless technique
Hrčak ID:
308846
URI
Datum izdavanja:
1.8.2023.
Posjeta: 309 *