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Case Reports
. 2021 Sep 4:2021:7433987.
doi: 10.1155/2021/7433987. eCollection 2021.

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

Yu Mizuno  1 , Atsushi Hirota  2 , Kazuyuki Hirooka  1 , Yoshiaki Kiuchi  1
Affiliations
Case Reports

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

Yu Mizuno et al. Case Rep Ophthalmol Med. .

Abstract

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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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Intraoperative photographs of the excision of the overhanging bleb (OHB). The yellow arrows are the range of the OHB. The OHB is avascular and thin walled (a). A portion of the OHB, which is easy to remove from the cornea, is excised immediately anterior to the limbus using scissors (b). Several sponges soaked in 0.04% MMC solution are applied for 5 min in the scleral surgical site (c). The incision were sutured using a 10-0 nylon suture (d).
Figure 2
Figure 2
Slit-lamp examination of the OHB in case 1 (a). Excision of the OHB (c). Corneal total higher-order aberrations before (b) and after bleb excision (d) with the simulated retinal images of Landolt C from corneal total higher-order aberrations on the right side.
Figure 3
Figure 3
Slit-lamp examination of the OHB before (a) and after bleb excision (c) in case 2. Corneal total higher-order aberrations before (b) and after bleb excision (d) with the simulated retinal images of Landolt C from corneal total higher-order aberrations on the right side.
See this image and copyright information in PMC

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