Complications: Bleb leaks

Abstract

Controversy exists regarding the effect of early postoperative bleb leaks on trabeculectomy outcomes. The Flourouracil Filtering Surgery Study found that early wound leaks were strongly associated with failure [29]. However, other authors have not found this association, though the number of leaks in their studies was small [1, 9, 18]. In my experience, the extent of early bleb leakage doesaffect trabeculectomy success. An incision line leak must be closed or the bleb will not form, conjunctival scarring will occur, and the bleb will eventually fail. However, small or pinpoint leaks often can heal spontaneously without affecting long-term bleb success. Other potential complications of an early leak are anterior chamber shallowing and a route for the development of endophthalmitis. Management of the leak depends on the leak's cause and severity. © 2010 Springer-Verlag Berlin Heidelberg.