Correspondence Address:
Dr. Kavitha Srinivasan
Department of Glaucoma, Aravind Eye Hospital, Puducherry - 605 007
India

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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 2}

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