Reviion of dyfunctional filtering bleb by conjunctival advancement with bleb preervation

PURPOE: To ae the outcome of advancing a conjunctival flap with preervation of the bleb in eye undergoing filtration bleb reviion after trabeculectomy. METHOD: A retropective review of cae from a univerity-baed referral practice identified 30 eye of 30 patient that had undergone bleb reviion after trabeculectomy by advancement of a conjunctival flap over the de-epithelialized bleb. ucce wa defined a reolution of the bleb-aociated complication neceitating the reviion (leak, hypotony, dicomfort) with maintenance of intraocular preure greater than or equal to 6 and le than or equal to 21 mm Hg without glaucoma medication. Qualified ucce met the above criteria but with the ue of glaucoma medication. ummary data including viual acuity were obtained. REULT: On the 30 eye, 30 conjunctival advancement procedure were performed. eventeen were for bleb leak, 10 for prolonged hypotony without bleb leak, and three for dyethetic bleb. Eighteen eye (60%) were claified a a complete ucce and 24 eye (80%) achieved at leat a qualified ucce. Cumulative probability of at leat qualified ucce wa 77% at 2 year. Failure included inadequate intraocular preure control (one eye), recurrent bleb leak (three eye), and hypotony without bleb leak (two eye). The mean preoperative intraocular preure for all eye increaed from 4.4 ± 3.7 mm Hg to 12.3 ± 6.2 mm Hg (P < .00001) at the final viit with a mean follow-up of 18.9 ± 15.5 month. Viual acuity improved or remained within 1 line of preoperative acuity in all but five patient. Complication included two patient with mild ptoi and four patient with hypertropia. CONCLUION: Advancement of a conjunctival flap with preervation the preexiting bleb often provide ucceful reolution of bleb-aociated complication.