title: Surgical results of bleb revision with scleral patch graft for late-onset bleb complications.
abstract: OBJECTIVE
  To describe the results of bleb revision with scleral patch graft for late-onset bleb-related complications.
  
  
  METHODS
  A retrospective case series between October 1996 and March 2003.
  
  
  RESULTS
  Fourteen patients had surgery for bleb leak, hypotonous maculopathy, dysesthesia, or bleb-associated infections after initial trabeculectomy or thermal sclerostomy. The preoperative intraocular pressure was 3.3 +/- 2.6 mm Hg, and the final intraocular pressure was 11.6 +/- 3.4 mm Hg after 10.1 +/- 6.8 months. Seven eyes required no further bleb revision or glaucoma medications. Visual acuity improved in 10 of 14 eyes. A second scleral patch graft revision was necessary in 3 eyes, but bleb leaks and hypotony resolved in all 14 eyes at last follow-up. Complications included bleb failure, bullous keratopathy progression, cataract progression, and ptosis.
  
  
  CONCLUSIONS
  Bleb revision with scleral patch graft is effective for treating late-onset bleb complications, resulting in improvement in visual acuity and resolution of hypotonous maculopathy, bleb leaks, and dysesthesia.
authors.affiliation: Department of Glaucoma, General Hospital of Athens, Athens Medical School, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Halkiadakis
authors.forename: Pauline
authors.initials: P
authors.lastname: Lim
authors.forename: Sayoko E
authors.initials: SE
authors.lastname: Moroi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D018463:Filtering Surgery / Q000009:adverse effects*; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014792:Visual Acuity