Scleral Patch Graft for Late Leaking Filtering Bleb

This video demonstrates the surgical technique of bleb repair in a 72-year-old patient who underwent filtering surgery 10 years earlier. Because the Seidel test was briskly positive and there was unhealthy necrotic tissue over and around the bleb area, local debridement with scleral patch grafting was performed. From the donor sclera, a partial-thickness scleral allograft was taken to cover the fistula. The graft was secured at the site of the fistula using a 10-0 nylon suture. The knots of all the sutures were buried. Following this, the fornix-based conjunctivo-tenon flap was advanced over the scleral patch graft to cover it completely. The patient completed 5 years of follow-up with good IOP control and the best-corrected visual acuity was 20/40 at the last follow-up.