Bleb Revision With Temporalis Fascia Autograft

Qu-Knafo, L.; Dû, Brivael Le; Boumendil, J.; Nordmann, Jean‐Philippe

doi:10.1097/ijg.0000000000000486

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…However, one of the fundamental problems associated with bleb needle redirection is that the ischemic conjunctiva remains, even after this treatment, which leads to the recurrence of bleb leakage. There are other options when the conjunctiva is insufficient or ischemic, such as autologous conjunctival patch grafting 22 , amniotic membrane transplantation 23 , scleral patch graft 24 , corneal patch graft 25 , and fascia autograft 26 . Despite these treatments, bleb leakage often cannot be treated successfully and treatment should be upgraded to a more invasive approach, such as conjunctival advancement 18 and MICS 27 .…”

Section: Discussionmentioning

confidence: 99%

“…However, this approach is often very invasive, in particular when there is a shortage of the conjunctiva, since the conjunctiva is advanced after the removal of the ischemic conjunctiva. Many other surgical techniques have been proposed, such as autologous conjunctival patch grafting 22 , amniotic membrane transplantation 23 , scleral patch graft 24 , corneal patch graft 25 , and fascia autograft 26 . Nonetheless, these treatments can be technically difficult and/or require special equipment.…”

Section: Introductionmentioning

confidence: 99%

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Bleb plication: a minimally invasive repair method for a leaking ischemic bleb after trabeculectomy

Sugimoto

Murata

Yamashita

et al. 2020

Sci Rep

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Bleb leakage is a serious complication of glaucoma filtering surgery. This study describes the method and the results of a new repair method for ischemic bleb leaks. The subjects were consecutive eleven eyes of 11 patients with bleb leakage who underwent the bleb plication surgery. The bleb plication surgery consisted of two steps: 1) bleb needle redirection to float the conjunctiva away from the sclera as extensively as possible around the ischemic conjunctiva; and 2) multiple “O-shaped” sutures were applied between the non-ischemic conjunctiva just outside the ischemic conjunctiva and corneal limbus. The ischemic conjunctiva was not removed, but undermined beneath the advanced non-ischemic conjunctiva. This bleb plication method was repeated until the leakage was sealed. All patients were followed up for at least 6 months after final bleb plication. After final bleb plication, no recurrence of bleb leakage was observed. Moreover, ischemic changes were no longer observed in the advanced non-ischemic conjunctiva. Pre-operative and final intraocular pressure was 3.2 ± 4.1 and 11.9 ± 2.8 mmHg, respectively. This new repair method of bleb plication was safe and effective in sealing the leakage. The conjunctiva is not excised, and hence it does not run out.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bleb plication: a minimally invasive repair method for a leaking ischemic bleb after trabeculectomy

Sugimoto

Murata

Yamashita

et al. 2020

Sci Rep

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“…[27][28][29][30][31] Although time consuming, success has been reported with the latter approaches to protect against late blebrelated infections. [32][33][34][35] When conjunctival tissue is scarce, a scleral patch graft, 36 amniotic membrane, 37 oral buccosal mucosa, 38 corneal patch graft, 39 and fascia lata 40 have all been tried. Unfortunately, surgical bleb revisions for recalcitrant bleb leaks still fail, and previously wellcontrolled glaucoma may become unstable.…”

Section: T He Leaking Filtering Bleb Is a Sight-mentioning

confidence: 99%

Incision-Free Minimally Invasive Conjunctival Surgery (MICS) for Late-Onset Bleb Leaks After Trabeculectomy (An American Ophthalmological Society Thesis)

Gupta

2019

American Journal of Ophthalmology

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This study describes an incision-free minimally invasive conjunctival surgical (MICS) technique to repair late-onset leaking blebs after trabeculectomy. METHODS: A surgical technique to repair leaking blebs without incision or excision of conjunctiva is described. This is followed by retrospective review of all patients treated at the Glaucoma Unit at St. Michael's Hospital for bleb leaks repaired with MICS from 2012 to 2017. With Research Ethics Board approval, clinical data obtained from the charts included demographic information, vision, intraocular pressure (IOP) data before and after surgery, need for additional medication, and complications. Resolution of the bleb leak without the need for additional therapy or intervention for glaucoma control was considered a success. RESULTS: The MICS approach was applied to 14 eyes of 13 consecutive patients with a leaking bleb. Mean age of presentation was 70.2 ± 14.8 years, and all patients had a history of mitomycin use at the time of glaucoma surgery. The onset of bleb leak following trabeculectomy ranged from 7 months to 16.3 years. Mean pre-operative IOP was 4.5 ± 2.8 mm Hg; IOP measured 12.3 ± 3.0 mm Hg immediately after the procedure. Complete resolution of the bleb leak was observed following surgery in all cases. The follow-up period ranged from 2 weeks to 61 months (10.2 ± 18.1). Recurrent bleb leak was reported in 1 patient 2 years following initial surgery. In all cases, the initially repaired filtering blebs remained functional at last followup, and no additional medications were required. CONCLUSIONS: The MICS procedure is an effective option for treating late-onset leaking blebs without cutting or excising conjunctival tissue. The minimal requirements of this method make it additionally accessible to low-resource settings. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

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Revisiting the Use of Deep Temporalis Fascia Grafts in Ophthalmology

Razlog,

Denoyer,

Baillif

et al. 2024

Seminars in Ophthalmology

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Bleb Revision With Temporalis Fascia Autograft

Abstract: Superficial temporalis fascia autograft seems to be an effective, safe, and easy technique for ophthalmologists. It is a new procedure in the management of late-onset bleb leakage.

Cited by 3 publications

References 19 publications

Bleb plication: a minimally invasive repair method for a leaking ischemic bleb after trabeculectomy

Bleb plication: a minimally invasive repair method for a leaking ischemic bleb after trabeculectomy

Incision-Free Minimally Invasive Conjunctival Surgery (MICS) for Late-Onset Bleb Leaks After Trabeculectomy (An American Ophthalmological Society Thesis)

Revisiting the Use of Deep Temporalis Fascia Grafts in Ophthalmology

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