title: Repair of a late-onset filtering bleb leak using a corneal graft shaped with an excimer laser.
abstract: A new method for repairing an area of late scleral necrosis and bleb leak after glaucoma-filtering surgery using mitomycin C (MMC) is described. In a 33-year-old female patient diagnosed with bilateral juvenile glaucoma, a bleb leak occurred 41 months after trabeculectomy with MMC in the left eye. A corneal stromal patch-graft shaped to the desired size using an excimer laser (Excimer-Laser-Corneal-Shaping-System, ELCS-S) was used to cover the scleral defect. This step was followed by water-tight closure of the conjunctiva. During the follow-up period of 12 months the leak remained successfully repaired and the intraocular pressure stayed between 8 and 14 mm Hg without medication. This technique that uses lamellar grafts of very large size should be considered when a surgical repair of a large leaking bleb is required, especially in cases with scleral tissue necrosis.
authors.affiliation: Department of Ophthalmology County Hospital, Salzburg, Austria. amistlberger@aon.at
authors.forename: A
authors.initials: A
authors.lastname: Mistlberger
authors.forename: R
authors.initials: R
authors.lastname: Biowski
authors.forename: G
authors.initials: G
authors.lastname: Grabner
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000637:transplantation*; D005260:Female; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D009336:Necrosis; D011183:Postoperative Complications / Q000601:surgery*; D012590:Sclera / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D014130:Trabeculectomy; D014792:Visual Acuity