Encapsulated Bleb Excision after Failed Needling

Drs. Monia Cheour and Ferchichi Molka discuss the case of a patient with a prior trabeculectomy who presented with an encapsulated bleb after failed needling. After traction suturing and cauterization around the encapsulated bleb, the surgeons created a peritomy and performed a wide subconjunctival dissection peripherally and posteriorly, making sure to have enough conjunctiva to cover the scleral flap later. The entire subconjunctival area was then gently cauterized in order to reduce bleeding. The conjunctiva was closed with 8-0 Vicryl sutures without relaxing incisions and 5-fluorouracil was injected subconjunctivally at the opposite side of the bleb.

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