The reopening of closed filtering blebs using the neodymium: YAG laser.
Four eyes underwent cicatricial closure of the filtering bleb within the 6 weeks postoperatively. They failed to respond to digital massage and conventional therapy, resulting in loss of bleb and elevated intraocular pressure. The average pre-YAG laser treatment intraocular pressure was 34.5 mmHg. Three hundred to five hundred applications from the mode-locked Neodymium:YAG laser ( Meditec ) delivered at 3.5 mJ were directed through a goniocontact prism to the surgical area. Prompt vaporization of scar tissue and sclera resulted in a dramatic reversal of the pathology. Forty-eight hours after treatment and with a cessation of carbonic anhydrase inhibitors, an average 20 mm Hg drop in intraocular pressure was achieved. The bleb reformed in each case and maintained its patency for a minimum follow-up of 6 months.
D000368:Aged; D002387:Cataract Extraction; D002921:Cicatrix / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012590:Sclera / Q000601:surgery; D014129:Trabecular Meshwork / Q000601:surgery; D014945:Wound Healing