{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:03:43Z","timestamp":1790730223935,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T00:00:00Z","timestamp":1590451200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Bleb dysfunction may occur as a late complication following glaucoma filtration surgery. Over-filtering, thinning and cystic blebs can lead to hypotony, leak and corneal dellen. We report our surgical management and outcomes of this specific entity using donor scleral patch grafts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a 10-year non-comparative, retrospective interventional case series. Bleb reconstruction involved excision of encysted conjunctiva and sclera to identify the original fistula. A functioning donor scleral patch graft was sited over this with fixed and releasable sutures and the conjunctiva advanced. Intraocular pressure, visual acuity and post-operative issues were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 18 eyes of 17 patients with mean age 65\u2009years (standard deviation 13.5) were included. Trabeculectomy was the primary procedure in 72% ( n\u2009=\u200913) and deep sclerectomy in 28% ( n\u2009=\u20095). Bleb leak accounted for 61% ( n\u2009=\u200911), hypotony 33% ( n\u2009=\u20096) and corneal dellen 6% ( n\u2009=\u20091). Mean pre-operative intraocular pressure was 7\u2009mm\u2009Hg (standard deviation 4.6) which increased to 18.5\u2009mm\u2009Hg (standard deviation 12) at day 1 ( p\u2009&lt;\u20090.001), 11.8\u2009mm\u2009Hg (standard deviation 4.6) at 3\u2009months ( p\u2009&lt;\u20090.05), 12.1\u2009mm\u2009Hg (standard deviation 4.2) at 1\u2009year ( p\u2009&lt;\u20090.01) which was maintained at 12.1\u2009mm\u2009Hg (standard deviation 5.3) at last follow-up ( p\u2009&lt;\u20090.001). Post-operative interventions included bleb needling, re-suturing, suture removal, further glaucoma management, bleb leak and cataract surgery. Visual acuity also improved post-operatively and was maintained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Reconstruction of the filtering bleb architecture with donor sclera results in improved intraocular pressure while maintaining visual acuity. Post-operative care is required to support the restored bleb function. Our findings support the use of scleral patch graft as an effective and safe method for the long-term management of hypotony and bleb leak as a late complication of glaucoma filtration surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1120672120924343","type":"journal-article","created":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T03:15:00Z","timestamp":1590462900000},"page":"1039-1046","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Bleb reconstruction using donor scleral patch graft for late bleb leak and hypotony"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6823-6472","authenticated-orcid":false,"given":"Michael","family":"O\u2019Rourke","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Moran","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoife","family":"Doyle","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, 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