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OPHTHALMIC IMAGE
Year : 2022  |  Volume : 60  |  Issue : 1  |  Page : 130-131

Scleral patch graft for overhanging bleb


Department of Glaucoma, Aravind Eye Hospital, Puducherry, India

Date of Submission22-Jun-2021
Date of Decision27-Sep-2021
Date of Acceptance01-Oct-2021
Date of Web Publication22-Mar-2022

Correspondence Address:
Dr. Kavitha Srinivasan
Department of Glaucoma, Aravind Eye Hospital, Puducherry - 605 007
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_91_21

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How to cite this article:
Pabolu C, Srinivasan K. Scleral patch graft for overhanging bleb. TNOA J Ophthalmic Sci Res 2022;60:130-1

How to cite this URL:
Pabolu C, Srinivasan K. Scleral patch graft for overhanging bleb. TNOA J Ophthalmic Sci Res [serial online] 2022 [cited 2022 Jun 29];60:130-1. Available from: https://www.tnoajosr.com/text.asp?2022/60/1/130/340377



A man aged 55 years, 3 years post fornix-based trabeculectomy with mitomycin C in the right eye (RE), presented with whitish mass RE, obscuring vision. Visual acuity was 20/120 and intraocular pressure (IOP) was 3 mmHg. RE showed cystic, diffuse avascular bleb, overhanging on the cornea covering superior half of the pupi. Fundus showed advanced disc damage. An overhanging bleb is a complication of trabeculectomy, especially when antimetabolites are used. Bleb excision was done following which underlying scleral defect was noted. The scleral defect was closed with partial thickness rectangular (4 x 5 mm) scleral patch graft [Figure 1]A, [Figure 1]B, [Figure 1]C, [Figure 1]D using nylon sutures. IOP got normalized post-operatively in the next few weeks. [Figure 2]E, [Figure 2]F demonstrates pre and post-operative anterior segment images of the RE. Bleb revision with scleral patch graft is effective for treating overhanging bleb.[1],[2]
Figure 1: Figure A shows the bleb being excised, figure B demonstrates underlying scleral defect (black arrow), figure C demonstrates the creation of 4x5mm rectangular partial scleral graft from donor sclera, figure D demonstrates the patch graft, fixed with nylon sutures (blue arrow)

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Figure 2: Figure E demonstrates the overhanging bleb, covering the cornea reaching almost the pupillary axis, figure F shows post-operative anterior segment image, with good conjunctival apposition, intact scleral patch graft and well-formed anterior chamber

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Au L, Wechsler D, Spencer F, Fenerty C. Outcome of bleb revision using scleral patch graft and conjunctival advancement. J Glaucoma 2009;18:331-5.  Back to cited text no. 1
    
2.
Halkiadakis I, Lim P, Moroi SE. Surgical results of bleb revision with scleral patch graft for late-onset bleb complications. Ophthalmic Surg Lasers Imaging 2005;36:14-23.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2]



 

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