Histopathology and treatment of a huge overhanging filtering bleb

Ouyang, Pingbo; Qi, Xin; Duan, Xuanchu

doi:10.1186/s12886-016-0353-7

Cited by 6 publications

(16 citation statements)

References 11 publications

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“…Most OFBs have a certain degree of mobility, and can be pushed easily. Their etiology is explained as follows: (1) The use of antiproliferative drugs during ltering surgery results in the thinning of the wall of the ltering bleb [5,[17][18][19]. (2) This thinning leads to excessive ltration or even leakage from the bleb[6, 18, 19], which then sags under the in uence of gravity [18,19] and the squeezing pressure of eyelid closure [19].…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological features of corneal invasion by filtering bleb

Shi

Zhou

Chen

et al. 2022

Preprint

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Purpose: : To describe the clinicopathological characteristics and explore the possible etiology of cornea invasion by filtering bleb (CIFB) after filtering surgery. Methods: We reviewed 22 patients treated for CIFB between March 2005 and March 2022. The patients were followed up for more than 1 year. Slit-lamp examination, optical coherence tomography (OCT), ultrasound biomicroscopy, and histopathological examination were performed to observe the morphology of the bleb and depth of corneal invasion. Depending on the severity of the lesion, treatments consisting of local massage, acupuncture separation, or surgical resection were administered. Results: The mean age of the patients was 56.3 ± 8.8 years. All patients underwent filtering surgery in the moderate or advanced stage of glaucoma. The filtering bleb was closely connected with the cornea, and its posterior boundary was locally adhered. Forward displacement of the internal opening of the filtering bleb was found in 4 of 7 surgically treated patients. OCT and pathological examination showed that the filtering blebs invaded the corneal stroma. Removal of the adhesion of the posterior boundary of the filtering bleb by different treatment methods successfully improved the patients’ conditions. Conclusion: Filtering blebs can invade the corneal stroma. Adhesion of the posterior boundary and forward displacement of the internal opening of the filtering bleb are the possible causes of CIFB. Removal of the adhesion of the posterior boundary of the filtering bleb can halt the progression of CIFB.

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Section: Discussionmentioning

confidence: 99%

“…In patients with BMOC, the ltering bleb crosses the corneoscleral junction and enters the corneal region, causing a plugging sensation, tears, increased intraocular pressure (IOP), and other symptoms. In severe cases, the pupil is blocked, resulting in a decrease in the best-corrected visual acuity (BCVA) [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological features of corneal invasion by filtering bleb

Shi

Zhou

Chen

et al. 2022

Preprint

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“…OHBs are a late complication following glaucoma filtration surgery, and the incidence of these blebs appears to be increasing with the use of antimetabolites [ 5 ]. Antimetabolites aid the antiproliferation of fibroblast cells, thereby preventing excessive postoperative scarring and enhancing the growth of the large bleb [ 6 ]. The mechanism underlying the formation of OHBs is complex.…”

Section: Discussionmentioning

confidence: 99%

Improvements in Optical Characteristics after Excision of an Overhanging Bleb Developed following Trabeculectomy

Mizuno

Hirota²,

Hirooka

et al. 2021

Case Reports in Ophthalmological Medicine

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Introduction. To examine the corneal total higher-order aberrations before and after the excision of an overhanging bleb that developed following trabeculectomy. Case Presentation. Two patients who developed overhanging blebs following trabeculectomy with a fornix-based conjunctival flap using mitomycin C (MMC) were assessed. We measured the corneal total higher-order aberrations for a 4 mm pupil diameter using the TOPCON KR-1W wavefront analyzer and the visual acuity before and after bleb excision. The corneal total higher-order aberration (HOA) improved from 0.50 μm to 0.38 μm in case 1 and from 0.59 μm to 0.49 μm in case 2 after bleb excision. The intraocular pressure was identical before and after bleb excision in both cases. No significant changes in the best-corrected visual acuity (BCVA) were noted in case 1; however, BCVA was improved from 20/25 to 20/20 in case 2. Both cases showed improvements in the symptoms of dysesthesia. Conclusion. Excision of the overhanging bleb developed following trabeculectomy may have beneficial possibility in some cases where corneal total HOA is affected and reduces the symptoms of dysesthesia.

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“…Pterygium is a degenerative condition of the conjunctiva with the subconjunctival tissue invading the cornea by destroying superficial layers of stroma and Bowman’s membrane [ 26 ]. The histopathology of OHB revealed tight connections with corneal tissues or the corneoscleral limbus and multiloculated cystic, rather than simply leaning on the cornea, suggesting that OHB induces changes in the ocular surface [ 4 , 27 ]. Therefore, we consider that OHB, in which the conjunctiva invades the cornea, similar to the pterygium, may also influence corneal HOAs.…”

Section: Discussionmentioning

confidence: 99%

“…However, following TLE, patients occasionally complain of foreign body sensation, excessive tearing, sensitivity to light, and vision changes. Some of these patients may have overhanging blebs (OHBs), which are defined as oversized filtering blebs that cover part of the cornea and are caused by tear film instability [ 4 ]. Their incidence appears to be increasing with the introduction of antimetabolites [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Overhanging Bleb on Corneal Higher-Order Aberrations after Trabeculectomy

Mizuno

Hirooka

Kiuchi

2021

JCM

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Recent advances in ocular aberrometry have revealed that ocular surgery increases ocular and corneal higher-order aberrations. This retrospective single-center study aimed to examine the effects of the overhanging bleb on corneal higher-order aberrations using a wavefront analyzer. We included 61 eyes from 50 patients with overhanging bleb after trabeculectomy with a fornix-based conjunctival flap using mitomycin C (overhanging bleb group) and 65 eyes from 54 glaucoma patients with no history of glaucoma surgery (control group). Corneal higher-order aberrations (total higher-order aberrations, coma aberrations, coma-like aberrations, spherical aberrations, and spherical-like aberrations) on a 4 mm pupil diameter were measured using the TOPCON KR-1W wavefront analyzer. Corneal coma aberrations were higher in the overhanging bleb group than in the control group (0.16 ± 0.13 μm and 0.10 ± 0.05 μm, respectively; p = 0.042). Corneal coma-like aberrations were also higher in the overhanging bleb group than in the control group (0.31 ± 0.32 μm and 0.16 ± 0.09 μm, respectively; p = 0.022). With an increasing ratio of cornea covered by the bleb to the entire cornea, all corneal higher-order aberrations increased except for corneal coma-like aberrations. Overhanging bleb after trabeculectomy with a fornix-based conjunctival flap using mitomycin C and its size influenced corneal higher-order aberrations.

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Histopathology and treatment of a huge overhanging filtering bleb

Cited by 6 publications

References 11 publications

Clinicopathological features of corneal invasion by filtering bleb

Clinicopathological features of corneal invasion by filtering bleb

Improvements in Optical Characteristics after Excision of an Overhanging Bleb Developed following Trabeculectomy

Influence of Overhanging Bleb on Corneal Higher-Order Aberrations after Trabeculectomy

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