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    Free Conjunctival Autograft in the Management of Mitomycin-Treated Unhealthy Bleb With Hypotony in Pseudophakic Glaucoma

    AAO2021 Video Program

    The goal of glaucoma filtering surgery is to create a functioning filtering bleb with healthy conjunctiva. The present video highlights the surgical technique of managing a huge, unhealthy, mitomycin-treated conjunctiva with multicystic changes and hypotony in an adult with pseudophakic glaucoma. After applying mild bipolar cautery, the surface tissue was coagulated and debrided with a surgical blade. Free conjunctivo-tenon autograft was harvested from the lower bulbar conjunctiva and transplanted over the bleb with proper limbal orientation. Multiple interrupted 10-0 nylon sutures were applied to secure the graft with healthy conjunctiva. Anteriorly, the graft was sutured to the debrided peripheral cornea with three horizontal mattress sutures. The exposed donor area was reduced by pooling and suturing the conjunctiva on both the sides. The six-month postoperative appearance of the graft showed healthy bleb with good IOP control without any antiglaucoma medication.