Compression Sutures for Overfiltering Bleb

Dr. Marlene Moster demonstrates a transconjunctival technique for compression sutures to treat hypotony in patients with an overfiltering bleb. After topical anesthesia is administered, full-thickness, 10-0 nylon sutures are placed through both conjunctiva and sclera. The sutures are kept as deep and radial as possible, and then tied tightly in the former trabeculectomy site. By compressing the tissue in the immediate area, blood is prevented from entering the anterior chamber and leaks are limited. The sutures can be left to dissolve or removed. In this case, all sutures but one were left to incorporate into the bleb. This technique is easy to adopt and minimally invasive, and it does not preclude further bleb revision surgery if needed.