title: Filtering bleb modification with a THC:YAG (Holmium) laser.
abstract: OBJECTIVE
  To present a method for remodeling oversized blebs using the THC:YAG laser and describe its use in treating hypotony and bleb leaks.
  
  
  METHODS
  Retrospective medical record review of 13 patients who underwent holmium laser bleb revision.
  
  
  RESULTS
  Thirteen eyes of 13 patients were analyzed. All the patients had an oversized bleb and 2 patients presented an associated late-onset leaking bleb. Mean preoperative IOP was 4.1 mm Hg. THC:YAG laser energy was applied to the bleb to remodel and/or close the leak. After a mean follow up of 17.3 months, the mean IOP was 7.84 mm Hg +/- 2.3. Postsurgery complications included hyphema and the inadvertent rupture of a conjunctival microcyst. Visual acuity improved in 9 of the eyes and remained stable in 4 of the eyes.
  
  
  CONCLUSIONS
  The THC:YAG laser can be used effectively to sculpt large blebs, reduce symptoms associated with large blebs, increase IOP in hypotonous eyes, and under specific circumstances, close bleb leaks.
authors.affiliation: Glaucoma Research & Education Group, San Francisco, California 94102, USA.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Iwach
authors.forename: Maria E
authors.initials: ME
authors.lastname: Delgado
authors.forename: Misato
authors.initials: M
authors.lastname: Adachi
authors.forename: Motryja
authors.initials: M
authors.lastname: Makarewycz
authors.forename: Patricia
authors.initials: P
authors.lastname: Wong
authors.forename: Ngoc
authors.initials: N
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018463:Filtering Surgery / Q000009:adverse effects / Q000379:methods*; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006695:Holmium; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014792:Visual Acuity
chemical_list: D006695:Holmium