Surgical reduction of dysesthetic blebs.
Dysesthetic blebs can complicate filtration surgery. Lubrication often reduces symptoms; however, some cases require surgical intervention. Limited conjunctivoplasty reduces the symptoms of dysesthetic blebs without sacrificing control of intraocular pressure (IOP). However, this may not sufficiently lower these blebs, particularly if the bleb is thick and dense. We describe a modified conjunctivoplasty technique that includes removal of subconjunctival scar tissue within the interpalpebral fissure and provide a 1-year follow-up of 13 eyes treated in this manner. All patients reported rapid, complete symptom resolution. The IOP was controlled in all 13 eyes following conjunctivoplasty; 3 required topical antiglaucoma therapy. Subconjunctival scar tissue may contribute to the formation of dysesthetic blebs owing to its thickness and by encouraging local dissection of aqueous humor. Our report demonstrates that removal of this tissue does not compromise IOP control when performed with conjunctivoplasty.
Lloyd
Michael
M
Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA.
Giegengack
Matthew
M
Morrison
John C
JC
D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000187:drug effects / Q000601:surgery*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D010292:Paresthesia / Q000188:drug therapy / Q000601:surgery*; D018918:Phacoemulsification; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity
D000477:Alkylating Agents; D016685:Mitomycin