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| OPHTHALMIC IMAGE |
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| Year : 2022 | Volume
: 60
| Issue : 1 | Page : 130-131 |
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Scleral patch graft for overhanging bleb
Chinmayee Pabolu, Kavitha Srinivasan
Department of Glaucoma, Aravind Eye Hospital, Puducherry, India
| Date of Submission | 22-Jun-2021 |
| Date of Decision | 27-Sep-2021 |
| Date of Acceptance | 01-Oct-2021 |
| Date of Web Publication | 22-Mar-2022 |
Correspondence Address:
Dr. Kavitha Srinivasan
Department of Glaucoma, Aravind Eye Hospital, Puducherry - 605 007
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/tjosr.tjosr_91_21
How to cite this article:
Pabolu C, Srinivasan K. Scleral patch graft for overhanging bleb. TNOA J Ophthalmic Sci Res 2022;60:130-1 |
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 | |  |
| 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.  |
| 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. |
[Figure 1], [Figure 2]
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