Algorithm approach for revision surgery following late-onset bleb complications after trabeculectomy: Long-term follow-up Algoritmo de abordagem para cirurgia de revisão nas complicações da bolha de início tardio após trabeculectomia: Acompanhamento de lo

Abstract

Purpose: The aim of this study was to introduce a reproducible algorithm for the surgical management of late-onset (>2 months) bleb complications after trabeculectomy with mitomycin C. Methods: We performed a retrospective review of eyes treated using a reproducible algorithm approach by a single surgeon for the surgical management of late-onset bleb complications from July 2006 to April 2014. Exclusion criteria were bleb revision with less than 3 months of follow-up or bleb revision combined with other glaucoma procedures at the time of surgery. Success was evaluated using the Kaplan-Meier survival method and defined as achieving all of the following criteria: Primary surgery indication resolved, no additional surgery required for decreasing the intraocular pressure (IOP), and IOP of >6 mmHg and <18 mmHg. Results: Twenty-three eyes from 20 patients were evaluated. Indications for bleb revision were hypotonic maculopathy (47.8%), bleb leak (30.4%), and dysesthetic bleb (21.7%). The ove