What is a bleb leak in the eye?
Bleb leaks are part of all surgical glaucoma practices, and they can occur after any filtering surgery, during both the early and late postoperative periods. Because these leaks can lead to serious complications, proper detection and successful management are paramount.
Why do trabeculectomy fail?
The main cause of a failed trabeculectomy is episcleral or subconjunctival fibrosis. When a trabeculectomy procedure fails and cannot be rescued, subsequent procedures include a second trabeculectomy, placement of an aqueous shunt, or a cyclodestructive procedure.
What is MMC in trabeculectomy?
The introduction of mitomycin C (MMC) as an adjunct to trabeculectomy was a major advance in the ability to improve the intraocular pressure (IOP) lowering efficacy of the procedure. MMC is an antineoplastic antibiotic agent isolated from the fermentation filtrate of Streptomyces caespitosus, has been shown to …
How do you fix a leaky bleb?
Therapeutic modalities to treat early leaking blebs include pressure patching, a bandage contact lens, Simmon’s shell, a symblepharon ring, fibrin tissue glue, cyanoacrylate glue, and surgical revision. The last option is the most efficient.
How do you describe a trabeculectomy bleb?
Trabeculectomy is a filtering surgery where an ostium is created into the anterior chamber from underneath a partial thickness scleral flap to allow for aqueous flow out of the eye. The aqueous flows into the subconjunctival space, usually leading to an elevation of the conjunctiva, referred to as a filtering bleb.
What is MMC operation?
Background: Trabeculectomy is performed as a treatment for glaucoma to lower the intraocular pressure (IOP). Mitomycin C (MMC) is an antimetabolite used during the initial stages of a trabeculectomy to prevent excessive postoperative scarring and thus reduce the risk of failure.
Do eye blebs go away?
“In most cases, you can leave them alone. You can just simply control the elevated intraocular pressure [IOP] with anti-glaucoma medication, particularly aqueous suppressants, and the bleb will gradually resume functioning in most cases.”
Does caffeine affect eye pressure?
Caffeine can increase eye pressure, which is problematic for patients with glaucoma because it’s the primary factor that causes the disease to develop. Glaucoma develops when fluid builds up in the front part of the eye and increases pressure on the optic nerve.
When do you use mitomycin C?
Mitomycin-C is an alkylating, anti-tumor antibiotic, generally used in surgery because of its ability to inhibit fibroblast proliferation and suppress vascular ingrowth—two parts of the healing process that can undercut the beneficial effect of a trabeculectomy bleb by producing scarring that stops aqueous outflow.
What happens when a bleb ruptures?
When a bleb ruptures the air escapes into the chest cavity causing a pneumothorax (air between the lung and chest cavity) which can result in a collapsed lung. If blebs become larger or come together to form a larger cyst, they are called bulla.
How do you pop a bleb?
Gently massage the nipple to release the blister. Also, try applying pressure behind the nipple. This treatment works best when carried out after a bath, shower, or saline soak, as the skin will be very soft. Do not apply so much pressure to the nipple that it causes pain.