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Bleb scarring is an insidious process over time as a consequence of excessive subconjunctival fibrosis. Timely recognition and early intervention utilizing a stepped-up approach are important for resuscitating the bleb and salvaging the trabeculectomy. Over-filtration and leaky bleb on the other end of the spectrum lead to failure of optimal bleb function and require a different management approach. This review discusses in detail various surgical techniques to revive dysfunctional blebs with a special focus on bleb needling. Timely identification and multifaceted management of bleb-related complications is the key to ultimately improving long-term success rates and patient outcomes.<\/jats:p>","DOI":"10.4103\/ijo.ijo_1233_24","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T12:09:08Z","timestamp":1740139748000},"page":"S197-S206","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Bleb resuscitation of failing, leaking and dysfunctional blebs: A review"],"prefix":"10.4103","volume":"73","author":[{"given":"Arshi","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirti","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aastha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"R1-20250221","first-page":"55","article-title":"Wound healing after glaucoma surgery: how to manage it?","author":"Collignon","year":"2005","journal-title":"Bull Soc Belge Ophtalmol"},{"key":"R2-20250221","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.suc.2009.03.006","article-title":"The physiology of wound healing: injury through maturation","volume":"89","author":"Teller","year":"2009","journal-title":"Surg Clin North Am"},{"issue":"Suppl 1","key":"R3-20250221","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s12886-015-0134-8","article-title":"Pathobiology of wound healing after glaucoma filtration surgery","volume":"15","author":"Yamanaka","year":"2015","journal-title":"BMC Ophthalmol"},{"key":"R4-20250221","first-page":"342","article-title":"Reopening of non-functional filters\u2014simplified surgical techniques","volume":"70","author":"Swan","year":"1975","journal-title":"Trans Am Acad Ophthalmol Otolaryngol"},{"key":"R5-20250221","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0039-6257(98)00025-3","article-title":"Dysfunctional filtering blebs","volume":"43","author":"Azuara-Blanco","year":"1998","journal-title":"Surv Ophthalmol"},{"key":"R6-20250221","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5005\/jp-journals-10028-1239","article-title":"Improving glaucoma surgical outcomes with adjunct tools","volume":"12","author":"J Lu","year":"2018","journal-title":"J Curr Glaucoma Pract"},{"key":"R7-20250221","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1038\/eye.2001.152","article-title":"The National Survey of Trabeculectomy. 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