Long-term follow-up of partial bleb excision in late-onset bleb-related complications by a single surgeon using conjunctival advancement

Abstract

Purpose: The purpose of this study was to describe the long-term results of partial bleb excision in late-onset bleb-related complications by a single experienced surgeon using the same surgical technique. Patients and Methods: This was a retrospective study of 21 eyes of 11 women and 10 men aged 34 to 87 years (mean 64±12.8 y) who underwent first repair of late-onset bleb leaks with or without numerical hypotony (NH) and dysesthesia. The surgical technique consists of removing nonviable conjunctiva until the functional tissue becomes visible, thus adapting to individual conditions, and later conjunctival advancement. Complete success was defined as maintenance of intraocular pressure control without additional bleb revision, surgery, or glaucoma medications. Qualified success met these criteria, but with glaucoma medications. Results: The mean follow-up was 5.6±4.4 years (1 to 17 years). Sixty-two percent of the cases were considered complete success, and a moderate number of cases (19%) needed glaucoma medication for achieving qualified success at the end of the follow-up period. Interestingly, bleb leak with NH seems to have long-term outcomes, like the other bleb-related complications (in terms of success and failures), with a significant intraocular pressure increase at 1 month after revision that tended to remain within normal values and lead to visual acuity recovery without recurrent NH. Conclusions: Partial bleb excision seems to be a good technique for different late-onset bleb-related complications. Bleb leak with NH showed a good long-term response, like the other bleb revision indications.