title: Surgical revision of filtration blebs: a follow-up study.
abstract: OBJECTIVE
  To assess the clinical outcome of one technique for surgical revision of filtration blebs in terms of bleb function and intraocular pressure control.
  
  
  METHODS
  Retrospective analysis of 36 consecutive cases of leaking, overfiltrating, or oversized blebs treated with bleb excision and conjunctiva and Tenon advancement in a glaucoma referral center between January 1991 and December 1999. Surgical success was defined as a final intraocular pressure between 6 and 22 mm Hg with or without topical antiglaucoma medication, resolution of the bleb leak, hypotony maculopathy and symptoms, and no need for repeat glaucoma surgery.
  
  
  RESULTS
  With a minimum of 12 months and an average of 29.5 months of follow-up, the overall success rate was 86.1%, with 51.6% of patients not requiring medication. In the success group, mean (SD) intraocular pressure was 23.7 (5.9) mm Hg before the original trabeculectomy, 4.3 (3.7) mm Hg prior to revision surgery, and 13.5 (SD 3.8) mm Hg at the last follow-up visit after the revision surgery. Mean number of antiglaucoma medications was 2.1 (range, 1-4) before the original trabeculectomy, none before the revision surgery, and 0.8 (range, 0-3) at the last follow-up visit.
  
  
  CONCLUSIONS
  The surgical revision technique offers a definitive solution for most of these bleb complications and a satisfactory intraocular pressure control in the majority of patients.
authors.affiliation: Glaucoma Service, The Rotterdam Eye Hospital, Rotterdam, the Netherlands.
authors.forename: E J
authors.initials: EJ
authors.lastname: van de Geijn
authors.forename: H G
authors.initials: HG
authors.lastname: Lemij
authors.forename: J
authors.initials: J
authors.lastname: de Vries
authors.forename: P W T
authors.initials: PW
authors.lastname: de Waard
mesh_terms: D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery; D014130:Trabeculectomy / Q000379:methods*