Treatment of postfiltration bleb leaks with autologous blood.

Abstract

Managing filtration surgery bleb leaks can be difficult as well as frustrating. Treatment options traditionally have included aqueous suppressants, patching, and bleb compression devices. Previously, if conservative management failed, surgical revision was considered. Six patients with thin avascular blebs and discrete leaking holes (2 had had full-thickness procedures, 4 had had trabeculectomy with mitomycin C) underwent subconjunctival injection of approximately 1 ml of whole autologous blood. Injections were made just lateral and just medial to the domed cystic elevation of the blebs. Five of six eyes were leak-free by the second day after the procedure. No complications occurred. After 4 to 12 months of follow-up, four eyes are currently leak-free. In these eyes, intraocular pressure is between 8 and 12 mmHg. Subconjunctival peribleb injection of autologous blood may be a safe and helpful adjunct in treating selected postfiltration surgery bleb leaks.