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- Title
A novel bleb revision technique: lining with tenon's patch graft for treatment of large, ischemic, leaking blebs with severe conjunctival scarring after trabeculectomy.
- Authors
Akagi, Tadamichi; Togano, Tetsuya; Iikawa, Ryu; Igarashi, Ryoko; Arimatsu, Mao; Miyajima, Makoto; Sakaue, Yuta; Fukuchi, Takeo
- Abstract
Purpose: We report a new bleb lining technique with Tenon's patch graft for late-onset leakage from large ischemic bleb with severe conjunctival scarring and impractical conjunctival mobilization after trabeculectomy. Study design: Retrospective case series. Methods: This study includes six cases with late-onset leakage from large ischemic blebs. Small Tenon's tissue is dissected from the incisional site or a previously made inferior incision for Tenon's anesthesia. A passage is created from the small incision to the leaking area of the bleb using a bleb knife or micro scissors. The Tenon's tissue, stained with indocyanine green, is inserted under the ischemic bleb's conjunctiva. A transconjunctival compression suture is placed across the leaking point to fix the Tenon patch graft positionally. Results: In all cases, bleb leakage was completely sealed immediately after surgery. In 4 cases, the closure of the bleb leakage was maintained after surgery during the follow-up period (6–17 months). In two cases, bleb leakage recurred from different leaking points 7 or 9.5 months after the surgery; however, repeated tenon's patch lining revisions successfully closed these leakages. The intraocular pressure at the final visit was 5–13 mmHg (median, 10 mmHg) without glaucoma medication or additional glaucoma surgery. Conclusion: Tenon's patch-lining technique is a promising method for bleb leakage with large ischemic bleb and impractical conjunctival mobilization.
- Subjects
TRABECULECTOMY; SCARS; INTRAOCULAR pressure; INDOCYANINE green; POLYPOIDAL choroidal vasculopathy; CONJUNCTIVA
- Publication
Japanese Journal of Ophthalmology, 2024, Vol 68, Issue 1, p32
- ISSN
0021-5155
- Publication type
Article
- DOI
10.1007/s10384-023-01037-z