What is bleb revision surgery?
The goal of the surgery is to excise ischemic, fibrotic tissue around the scleral flap and reapproximate the conjunctiva at the limbal edge. The surgeon creates a deep conjunctival pocket and applies liberal amounts of mytomycin C (MMC) to the posterior conjunctiva to prevent future fibrosis.
How long do Trabeculectomies last?
It is successful about 60-80 percent of the time in controlling the eye pressure during a period of five years.
What happens when glaucoma surgery fails?
The main cause of a failed trabeculectomy is episcleral or subconjunctival fibrosis. When a trabeculectomy procedure fails and cannot be rescued, subsequent procedures include a second trabeculectomy, placement of an aqueous shunt, or a cyclodestructive procedure. CAN OCULAR COMPRESSION RESCUE A BLEB?
How long does an eye bleb last?
Recovering from a trabeculectomy. After surgery, immediate side effects include discomfort and blurry vision in the affected eye. The blurring may last for up to two weeks, but it can take up to 12 weeks for your eye to feel normal and see normally again.
What is bleb failure?
Blebs can fail because the internal ostium is blocked by the iris, a membrane or fibrin and vitreous. Episcleral fibrosis can cause closure of the flap margins lining the bleb and can cause an encapsulation. Collagen within the bleb occurs in 10% to 14% of cases. “The problem is how to manage these blebs,” Dr.
How do they remove blebs from lungs?
The operation for bleb resection can be done via mini-thoracotomy or thoracoscopy. The procedure is performed with general anesthesia using a special endotracheal tube that allows intentional collapse of the lung which is operated on. The procedure is performed through a series of small incisions.
How long is vision blurry after glaucoma surgery?
Blurred Vision and Minor Discomfort It’s common for your vision to become blurred after the procedure. This may cause poor eyesight that can last a few days or up to 6 weeks.
Can trabeculectomy be repeated?
Repeat trabeculectomy with MMC has high success and low complication rates in patients with previously failed trabeculectomy in spite of the need of higher number of anti-glaucoma medications.
Do eye blebs go away?
“In most cases, you can leave them alone. You can just simply control the elevated intraocular pressure [IOP] with anti-glaucoma medication, particularly aqueous suppressants, and the bleb will gradually resume functioning in most cases.” For the remainder, a variety of methods can cure the problems, said Dr.
How do you needle a bleb?
Needling of the bleb is performed in the outpatient clinic. After instillation of topical anesthetic and antibiotic drops, a cotton tip applicator soaked in topical anesthetic is applied for 2 minutes to the conjunctival site where the needle will enter. A lid speculum is placed in the eye.
Which is the best bleb treatment for glaucoma?
According to the Fluorouracil Filtering Surgery Study, trabeculectomies with multiple repeated postoperative subconjunctival 5-FU injections significantly increased bleb longevity and reduced rates of reoperation, especially among patients with prior histories of intraocular surgery. 8-10
How is a trabeculectomy revision done for glaucoma?
Trabeculectomy revision, or incisional removal of episcleral fibrosis at the site of a failed trabeculectomy, may be achieved through a variety of techniques. The appeal of this option for the glaucoma surgeon is multifaceted. The procedure does not sacrifice a new region of fresh conjunctiva.
Which is the best surgery to treat glaucoma?
D espite rapid growth in the number of surgical options for the management of glaucoma, trabeculectomy remains the gold standard surgical procedure. Newer microstents are also being utilized to create filtering blebs, but long-term outcomes are not yet available in the literature.
Are there any side effects of bleb revision?
Hypotony (and its potentially devastating sequelae), infection, bleeding, and inflammation are potential complications of trabeculectomy and bleb revision. What information is available about the safety of bleb needling?
