Soltau et al listed criteria for when to attempt the closure of a late onset filtering bleb. The authors are from the University of Miami, the New York Eye and Ear Infirmary, and the New York Medical College.


Patient selection: late-onset (more than 1 month after surgery) glaucoma filtering bleb


Indications for attempting the closure of late onset filtering bleb:

(1) history of bleb-related infection

(2) monocular patient

(3) decreased vision in the eye due to hypotonia (with corneal folds, maculopathy, a shallow or flat anterior chamber, or chronic choroidal effusion)


Methods of attempting closure:

(1) aqueous suppressants

(2) pressure patching

(3) over-sized contact lens

(4) laser therapy

(5) fibrin glue

(6) autologous blood patch

(7) cyanoacrylate glue

(8) conjunctival advancement

(9) autograft over the site


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