A new technique for encapsulated blebs filtration: Vitrector assisted cystectomy
AuthorGülkılık, İbrahim Gökhan
Karaman Erdur, Sevil
Kocabora, Mehmet Selim
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CitationGülkılık, İ. G., Karaman Erdur, S., Kocabora, M. S., Balcı, Ö., Eliaçık, M., Odabaşı, M. ... Özsütçü, M. (2018). A new technique for encapsulated blebs filtration: Vitrector assisted cystectomy. Journal Francais D Ophtalmologie, 41(1), E47-E49. https://dx.doi.org/10.1016/j.jfo.2016.11.030
We introduce a new technique for the management of encapsulated non filtering blebs which are unresponsive to needling procedure. A 21 year-old man with a visual acuity of 20/30 presented with encapsulated bleb in the left eye 4 weeks after a successful trabeculectomy operation with adjunctive mitomycin C for medically uncontrolled glaucoma. The internal ostium was patent on gonioscopic examination. Intraocular pressure was 35 mmHg despite multiple therapies with bimatoprost, brimonidine, and dorzalomide-timolol fixed combination. He underwent two consecutive bleb needling procedures with adjunctive subconjunctival 5-fluorouracil (5-FU) injections which were successful initially but encapsulated bleb recurred. The 5-FU augmented bleb needling was performed at the slit lamp after cleaning the patient’s eyelid and periorbital skin with 10% providone iodine followed by instillation of a drop of 5% providone iodine. Needling of the bleb was performed using a 27-gauge needle. The aim was to remove episcleral scarring which was obstructing the intrascleral pathway. This was followed by an injection of 0.1 mL of 5-FU solution (50 mg/mL) along the far posterior margins of the bleb area.