Bleb Management After Subconjunctival MIGS

In this interview from AAO 2018, Dr. Davinder Grover shares tips for managing fibrosis after MIGS surgery in the subconjunctival space. For surgeries with the Xen implant, the bleb is often not as pronounced due to chemosis, which may make visualization and needling difficult. To overcome these difficulties, he and his colleague designed the Grover-Fellman spatula, a 16-17 mm surgical tool with a blunt tip and sharp sides that can help dissect the bleb without fear of perforation. Postoperatively, he sutures sites if they are cytopositive, and switches patients to steroid and antibiotic drops.

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