 |
|
Late-Onset Bleb Leaks After Glaucoma Filtering Surgery
David S. Greenfield, MD;
Jeffrey M. Liebmann, MD;
Jimmy Jee, MD;
Robert Ritch, MD
Arch Ophthalmol. 1998;116:443-447.
Objective To determine the incidence of focal, late-onset, conjunctival bleb leaks after glaucoma filtering surgery.
Design Prospective, cross-sectional analysis.
Setting Tertiary care outpatient referral center.
Patients Consecutive patients who underwent glaucoma filtering surgery prior to June 1996 presenting for evaluation from September 2, 1996, through November 15, 1996. Five hundred twenty-five eyes of 525 consecutive patients were enrolled in the study.
Intervention Bleb height (elevated or flat), area (diffuse or localized), and wall thickness (thin, thick, or encapsulated) were classified. Each bleb was tested for focal leakage using a moistened fluorescein strip, cobalt blue illumination, and slit-lamp biomicroscopy. Diffuse transconjunctival aqueous flow did not qualify as a focal leak.
Main Outcome Measure Seidel-positive aqueous leakage.
Results Bleb leakage occurred in 14 eyes following trabeculectomy (mitomycin C treatment, 10 eyes; 5-fluorouracil treatment, 3 eyes; no antifibrosis agent, 1 eye) and in 1 eye following combined cataract and glaucoma surgery with adjunctive mitomycin C therapy. Bleb leakage occurred more frequently in eyes that received mitomycin C (10 [3.7] of 273 eyes) than 5-fluorouracil (3 [1.4] of 213 eyes) or no antifibrosis agent (1 [2.6] of 39 eyes), using Kaplan-Meier estimates (P=.008, log-rank test). Conjunctival blebs were significantly thinner after trabeculectomy with mitomycin C than with 5-fluorouracil (P=.001). Bleb wall thickness was greater following combined cataract and glaucoma surgery than following trabeculectomy alone (P=.008). Age (P=.84), sex (P=.68), race (P=.77), duration of mitomycin C exposure (P=.62), number of antiglaucoma medications (P=.16), and total 5-fluorouracil dose (P=.85) were not associated with late-onset leaks.
Conclusions The risk of late-onset focal bleb leakage increases following trabeculectomy with mitomycin C therapy. Late leakage after combined cataract and glaucoma surgery is infrequent.
From the Departments of Ophthalmology (Drs Greenfield, Liebmann, Jee, and Ritch) and Neurology (Dr Greenfield), The New York Eye and Ear Infirmary, New York, and New York Medical College, Valhalla.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Surgical reduction of symptomatic, circumferential, filtering blebs.
Anis et al.
Arch Ophthalmol 2006;124:890-894.
ABSTRACT
| FULL TEXT
Mitomycin C augmented glaucoma surgery: evolution of filtering bleb avascularity, transconjunctival oozing, and leaks
Anand et al.
Br. J. Ophthalmol. 2006;90:175-180.
ABSTRACT
| FULL TEXT
Histopathologic Features of Conjunctival Filtering Blebs
Francis et al.
Arch Ophthalmol 2005;123:166-170.
ABSTRACT
| FULL TEXT
Microarray Analysis of the Failure of Filtering Blebs in a Rat Model of Glaucoma Filtering Surgery
Esson et al.
IOVS 2004;45:4450-4462.
ABSTRACT
| FULL TEXT
Expression of Connective Tissue Growth Factor after Glaucoma Filtration Surgery in a Rabbit Model
Esson et al.
IOVS 2004;45:485-491.
ABSTRACT
| FULL TEXT
Outcomes of bleb excision and conjunctival advancement for leaking or hypotonous eyes after glaucoma filtering surgery
Tannenbaum et al.
Br. J. Ophthalmol. 2004;88:99-103.
ABSTRACT
| FULL TEXT
Adenovirus-Mediated Gene Therapy Using Human p21WAF-1/Cip-1 to Prevent Wound Healing in a Rabbit Model of Glaucoma Filtration Surgery
Perkins et al.
Arch Ophthalmol 2002;120:941-949.
ABSTRACT
| FULL TEXT
Incidence of Late-Onset Bleb-Related Complications Following Trabeculectomy With Mitomycin
DeBry et al.
Arch Ophthalmol 2002;120:297-300.
ABSTRACT
| FULL TEXT
Risk Factors for Late-Onset Infection Following Glaucoma Filtration Surgery
Jampel et al.
Arch Ophthalmol 2001;119:1001-1008.
ABSTRACT
| FULL TEXT
Enhanced Short-Term Plasmid Transfection of Filtration Surgery Tissues
Angella et al.
IOVS 2000;41:4158-4162.
ABSTRACT
| FULL TEXT
Bleb related ocular infection: a feature of the HELP syndrome
LIEBMANN and RITCH
Br. J. Ophthalmol. 2000;84:1338-1339.
FULL TEXT
Risk Factors for Glaucoma Filtering Bleb Infections
Soltau et al.
Arch Ophthalmol 2000;118:338-342.
ABSTRACT
| FULL TEXT
Human Anti-Transforming Growth Factor-{beta}2 Antibody: A New Glaucoma Anti-Scarring Agent
Cordeiro et al.
IOVS 1999;40:2225-2234.
ABSTRACT
| FULL TEXT
Conjunctival Advancement for Late-Onset Filtering Bleb Leaks: Indications and Outcomes
Budenz et al.
Arch Ophthalmol 1999;117:1014-1019.
ABSTRACT
| FULL TEXT
|
